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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.
More ...

Norway

Norway US Consular Information Sheet
November 10, 2008
COUNTRY DESCRIPTION:
Norway is a highly developed stable democracy with a modern economy.
The cost of living in Norway is high and tourist facilities are well developed and widely
available.
Read the Department of State Background Notes on Norway for additional information.

ENTRY/EXIT REQUIREMENTS:
Norway is a party to the Schengen agreement.
As such, U.S. citizens may enter Norway for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our fact sheet.

Contact the Royal Norwegian Embassy at 2720 34th Street NW, Washington, DC
20008-2714, Tel: 1-202-333-6000, web site: http://www.norway.org or the nearest Norwegian Consulate.
Consulates are located in Houston, Minneapolis, New York City, and San Francisco.
Information can also be obtained from the Norwegian Directorate of Immigration at http://www.udi.no.

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:
Norway remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Norway’s open borders with its European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
The U.S. government remains deeply concerned about the heightened threat of terrorist attacks against U.S. citizens and interests abroad.
In the post-9/11 environment, Norway shares with the rest of the world an increased threat of international Islamic terrorism. Norway was among a list of countries named as legitimate targets in al-Qa’ida audiotapes released as recently as, 2006.
Americans are reminded to remain vigilant with regard to their personal security and to exercise 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, as well as the Worldwide Caution, can be found.

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

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

CRIME INFORMATION:
Norway has a relatively low crime rate.
Most crimes involve the theft of personal property.
Residential burglaries, auto theft, and vandalism to parked cars also occur.
Most high-end value vehicles, especially in Oslo, have visible alarm system indicators to discourage joy riders or thieves.
Persons who appear affluent or disoriented may become targets of pick-pockets and purse-snatchers, especially during the peak tourist season (May-September).
Thieves frequently target tourists in airports, train stations, and hotels, particularly lobby/reception and restaurant areas.
Often such thieves work in pairs and use distraction as a method to steal purses or briefcases.
While passports are frequently stolen in the course of these thefts, money, credit cards, and jewelry are the actual objects of interest.
In some cases stolen passports are recovered.
Violent crime, although rare, occurs and appears to be increasing.
Some thieves or burglars may have weapons.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds 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.

Norway has a program to provide financial compensation to victims who suffer serious criminal injuries.
Claimants can obtain application forms from the Norwegian Criminal Injuries Compensation Authority at http://www.voldsoffererstatning.no/index.php?id=10.
Please contact the U.S. Embassy in Oslo for further information. For further information about possible U.S. compensation, see our information for Victims of Crime.

The national emergency telephone numbers in Norway, equivalent to the “911” emergency line, are: Police 112, Fire 110, Ambulance 113.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are widely available and of high quality, but may be limited outside the larger urban areas.
The remote and sparse populations in northern Norway, and the dependency on ferries to cross fjords of western Norway, may affect transportation and ready access to medical facilities.
The U.S. Embassy in Oslo maintains a list of emergency clinics in major cities.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Norway.
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:
Healthcare in Norway is very expensive and healthcare providers sometimes require payment at time of service.
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 Norway is provided for general reference only, and may not be totally accurate in a particular location or circumstance.


Public transportation in Norway is generally safe, and the maintenance and condition of urban roads are generally good.
Rural road conditions are fair and the availability of roadside assistance is limited.
Most roadways beyond the city limits of Oslo and other major cities tend to be simple two-lane roads.
In mountainous areas of Norway, the roads also tend to be narrow and winding, with many tunnels.
The northerly latitude can also cause road conditions to vary greatly, depending on weather and time of year.
Many mountain roads are closed due to snow from late fall to late spring.
The use of winter tires is mandatory on all motor vehicles from November to April.

Norwegian law requires that drivers always use their vehicle headlights when driving.
Norwegian law also requires drivers to yield to vehicles coming from the right.
In some, but not all, instances, major roads with “right of way” are marked.
Seatbelts are mandatory for drivers and passengers.

Norway has some of the strictest laws in Europe concerning driving under the influence of alcohol; those laws prescribe heavy penalties for drivers convicted of having even a low blood alcohol level.
Frequent road checks with mandatory breathalyzer tests and the promise of stiff jail sentences encourage alcohol-free driving.
The maximum legal blood alcohol content level for driving a car in Norway is .02 per cent.

Automatic cameras placed by the police along roadways help to maintain speed limits, which are often lower than in other European countries.
Fines – and sometimes even jail time – are imposed for violations.


Please refer to our Road Safety page for more information.
For specific information concerning Norwegian driver's permits, vehicle inspection, road tax and mandatory insurance, contact the Norwegian Tourist Board office at P.O. Box 4649, Grand Central Station, New York, New York 10163-4649 (tel.: 212-885-9700; fax: 212/885-9710) or visit their web site at http://www.norway.org/travel
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Norway’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Norway’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:
Please see our information on customs regulations.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living in or visiting Norway are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov, and to obtain updated information on travel and security within Norway. 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 Oslo near the Royal Palace at Henrik Ibsensgate 48; tel. 47/2244-8550 (24 hours), consular fax 47/2256-2751.
The Embassy’s web site is http://norway.usembassy.gov
*
*
*
*
*
This replaces the Consular Information Sheet dated April 23, 2008 to update the sections on Crime, Safety and Security, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Tue 11 Jun 2019
Source: Associated Press [edited]

Norwegian authorities said Tuesday [11 Jun 2019] they were trying to identify the source of water contamination that has sent dozens of people in southern Norway to the hospital. Since Thursday [6 Jun 2019], 55 people, including 13 children from Askoy, an island north of Bergen, have been hospitalized following the contamination. All have been discharged. Norwegian news agency NTB reported that in all, some 2000 people had fallen sick.

A one-year-old child on the island died last week [week of Mon 3 Jun 2019] of an infection in the digestive tract, but it was not clear whether it was linked to the contamination.

"None of the patients are critically ill," said Oeyvind Kommedal, a doctor with the Haukeland university hospital that carried out laboratory tests. "We have a good control of the situation." He said tests showed that the bacterium _Campylobacter_ has been found in 36 cases.

On Monday [10 Jun 2019], Baard Espeli, deputy mayor of the municipality of Askoy, also said that _E. coli_ was found in a reservoir that supplied part of the area's drinking water. Espeli said that reservoir has been closed, but it remains unclear how the bacteria contaminated it in the 1st place.

_Campylobacter_ is one of the main causes of diarrheal diseases and is considered the most common bacterial cause of human gastroenteritis. Infections are generally mild but can be fatal among very young children and the elderly.
========================
[It is not specifically stated that all the cases are on the island. The finding of _E. coli_ in the water reflects faecal contamination but not necessarily that _E. coli_ was a pathogen. The outbreak, as many from contaminated water, may be related to multiple pathogens.

Askoy is a municipality in Hordaland county, Norway. The island municipality is located in the Midhordland district of the county, sitting in a large group of islands immediately northwest of the city of Bergen. The administrative centre of the municipality is the urban village of Kleppesto on the south-eastern shore of the island of Askoy. Its location can be found on a map at <https://en.wikipedia.org/wiki/Ask%C3%B8y>. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Hordaland county, Norway: <http://healthmap.org/promed/p/32342>]
Date: Mon 6 May 2019
Source: News in English (Norway) [edited]

A Norwegian woman in her 20s who was bitten by a dog while travelling in Southeast Asia 2 months ago died Monday night [6 May 2019]. Hospital officials confirm that the woman was infected with the deadly rabies virus.

She's the 1st person to have [died of] rabies on the Norwegian mainland since 1815. Rabies is extremely seldom on the Scandinavian peninsula.

The woman was originally from Hordaland but lived in the county of Sogn og Fjordane. She died at the hospital in Forde, where she'd been in intensive care since last week [week of 29 Apr 2019].

Norwegian Broadcasting (NRK) reported that she was bitten by a dog while on a tour of Southeast Asia 2 months ago. The hospital wasn't alerted to her case until last [2 May 2019], when she was admitted after falling seriously ill. Test results confirmed the rabies virus on [Sat 4 May 2019].

There were several other Norwegians in her tour group from various places around the country. All of them have been alerted to her rabies infection and are being followed up by their local health care centres.
=======================
[This tragic event lacks detail. Reportedly, the victim was in a "tour group" to "South East Asia" (which country/ies?) including participants from various places in Norway.

Travellers must be aware of the rabies status in countries they are to visit. And a tourist, or, as a matter of fact, anybody getting bitten by a (stray?) dog in a rabies-endemic country, should immediately seek medical treatment, after thoroughly washing the bite wound.

Several worrying questions arise. Had the participants been informed, prior to travel, about health risks, rabies being just one of the potential hazards? Were medical care and advice sought following the bite? Were other co-travellers bitten as well?... - ProMED Mod.AS]

[HealthMap/ProMED-mail maps:
Date: Mon 1 Apr 2019
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]

re: ProMED-mail Tick-borne encephalitis - Norway: cattle
----------------------------------------------------------------------
Tick-borne encephalitis (TBE) is one of 8 zoonoses carried by ticks in Norway (the others are anaplasmosis, babesiosis, louping ill, Lyme borreliosis, relapsing fever, rickettsial spotted fever, and tularemia). As displayed in the following graphs, rates of human TBE are considerably lower than those of other tick-borne diseases in Norway, and below TBE rates reported by neighbouring countries. [1-3]

See graphs at

References
----------
1. Berger S. Infectious Diseases of Norway, 2019. 387 pages , 138 graphs, 858 references. Gideon e-books
2. Berger S. Tick-borne Encephalitis: Global Status, 2019. 89 pages , 49 graphs , 787 references. Gideon e-books
3. Gideon multi-graph tool,
-----------------------------------------------
Communicated by:
Prof Steve Berger
Geographic Medicine
Tel Aviv Medical Center
Israel
==========================
[ProMED-mail thanks Dr Berger for pointing out that TBE virus is not the only tick-borne zoonotic pathogen in Norway. The objective of the author's study, as they defined it, was narrowly focused on TBE in cattle. They chose to analyse unpasteurized cow milk for TBEV RNA and to study the presence of IgG antibodies to TBEV in the same animals. They found evidence for TBE virus infection in cattle in certain areas and pointed out potential risk of infection of humans who consume unpasteurized milk from positive herds. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Tue 15 Jan 2019
Source: Food Safety News [abridged, edited]

A traditional Norwegian fish dish has been recalled due to a link with a case of botulism. Torpet Fiskeoppdrettsanlegg AS recalled rakfisk due to suspicions that consumption can cause botulism. Rakfisk is a traditional Norwegian fish dish made from trout or char, salted and then fermented for up to a year before being eaten without cooking. The withdrawal applies to all varieties of the product that the company produced in 2018.

Rakfisk was sold via various market stalls in Trondelag, direct delivery from Torpet Fiskeoppdrettsanlegg AS, and via COOP stores in Alen, Brekken, Roros, and Os, according to the Norwegian Food Safety Authority (Mattilsynet). The one reported case is in a person who lives in Trondelag, in central Norway.

The Norwegian Institute of Public Health (Folkehelseinstituttet) said rakfisk from the company is the suspected source for the case of foodborne botulism. People who have rakfisk of this type in the refrigerator should throw the product out and not eat it. Those who have eaten it and have symptoms consistent with botulism should consult a doctor. The agency said toxins can develop under certain adverse conditions in the production of certain foods, such as rakfisk, cured meats, and canned items.

Previous botulism cases in Norway have been associated with rakfisk and home canned meats.

Botulism is a rare but life-threatening condition caused by toxins produced by _Clostridium botulinum_ bacteria. Onset of symptoms varies from a few hours to several days after exposure to the bacteria or toxins. Symptoms can include blurred or double vision, facial muscle weakness, difficulty swallowing, slurred speech and breathing difficulties.  [Byline: Joe Whitworth]
===================
[Given the vehicle, botulism type E is the likely culprit here.

The following was extracted from ProMED-mail Botulism, smoked fish - Finland ex Canada http://promedmail.org/post/20060721.2000: _Clostridium botulinum_ type E is naturally highly prevalent in aquatic environments and fish, leading to a high risk of contamination. The hot-smoking processes are usually too low to eliminate botulinum spores. Growth and toxin production from spores in vacuum-packed smoked fish products with anaerobic atmosphere and limited preservative factors is likely during extended storage at temperatures above 3 deg C (37.4 deg F). Therefore the most important factors controlling _C. botulinum_ growth and toxin production are efficient heat treatments, restricted shelf life, and continuous storage below 3 deg C (37.4 deg F). - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Norway:
Date: Sat 22 Dec 2018
Source: Outbreak News Today [edited]

Officials with the Norwegian Institute of Public Health report seeing an increase in listeriosis cases in December [2018], prompting a warning for high-risk groups.

According to an official notice Friday [21 Dec 2018] (computer translated), 6 cases were reported this month [December 2018] when the country typically sees 1-2 cases a month.

Four of the 6 patients reported in December [2018] are from Hedmark and Oppland. Health officials are working to identify if there is a common food source linked to the increase in cases.

Listeriosis is usually transmitted through food, especially long-life foods that are refrigerated and eaten without further heat treatment. Many of these food products are popular as Christmas foods and can be found at many Christmas parties.

People in the risk groups for listeriosis (i.e., pregnant women, persons with impaired immune systems, and the elderly with impaired general condition) should, as usual, avoid food products that may pose a risk to _Listeria_ infection, says consultant Hans Blystad at the Norwegian Institute of Public Health.

Examples of such food products are
- Rakfisk;
- Products made from unpasteurized milk; and
- Soft and semi-soft cheeses, such as brie, camembert, and other molds, whether or not they are made from pasteurized milk.

Consumption of food contaminated with _L. monocytogenes_ can cause listeriosis, a serious infection that primarily affects older adults, persons with weakened immune systems, and pregnant women and their new-borns. Less commonly, persons outside these risk groups are affected.

Listeriosis can cause fever, muscle aches, headache, stiff neck, confusion, loss of balance, and convulsions, sometimes preceded by diarrhoea or other gastrointestinal symptoms. An invasive infection spreads beyond the gastrointestinal tract. In pregnant women, the infection can cause miscarriages, stillbirths, premature delivery, or life-threatening infection of the newborn.

In addition, serious and sometimes fatal infections occur in older adults and persons with weakened immune systems. Listeriosis is treated with antibiotics. Persons in the higher-risk categories who experience flu-like symptoms within 2 months after eating contaminated food should seek medical care and tell the healthcare provider about eating the contaminated food.
=====================
[Hedmark is a county in southeastern Norway, bordering Sweden to the east and Oppland to the west. Hedmark is one of the less urbanized areas in Norway; about half of the inhabitants live on rural land (<https://en.wikipedia.org/wiki/Hedmark>). Hedmark and Oppland are the only Norwegian counties with no coastline. A map of Norwegian counties can be found at <https://bluerose.karenlmyers.org/wp/scandinavia/norway/>.

Because _Listeria monocytogenes_, a Gram-positive bacterium that causes listeriosis, can multiply at refrigerator temperatures, _Listeria_-contaminated refrigerated, ready-to-eat products that do not require further cooking before eating, such as smoked salmon or cold-cut meats (e.g., ham), are recognized as potential sources for listeriosis. Unpasteurized milk and cheese and other milk products made from unpasteurized milk are other frequent sources of listeriosis. However, the source in some outbreaks has been contamination with _Listeria_ only after pasteurization.

Serotyping of _L. monocytogenes_ strains, based on variations in the somatic (O) and flagellar (H) antigens, has determined that only 3 (1/2a, 1/2b, and 4b) of the 12 serotypes of _L. monocytogenes_ cause 95% of human cases; serotype 4b is most commonly associated with outbreaks (<https://www.cdc.gov/listeria/pdf/listeriainitiativeoverview_508.pdf>). Genotyping the clinical isolates from the 6 ill people, if they match, will establish that we are dealing with a common-source outbreak, and genotyping isolates from potential sources will establish transmission pathways, if they match the clinical isolates. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
More ...

Netherlands

The Netherlands - US Consular Information Sheet
January 04, 2007
COUNTRY DESCRIPTION:
The Netherlands is a highly developed, stable democracy.
Tourist facilities are available throughout the Kingdom.
Read the Department of State
ackground notes on The Netherlands for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required.
Visas are not required for U.S. citizens for tourist visits of up to 90 days.
That period begins when you enter any of the Schengen group of countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden.
To be admitted into the Netherlands, travelers must have a passport with a validity that exceeds their intended stay, a return airline ticket, and enough money to finance the planned stay.
For further information on entry requirements, contact the Embassy of the Netherlands at 4200 Linnean Ave. N.W., Washington, D.C. 20008, telephone (202) 244-5300, or one of the Dutch consulates in Chicago, Houston, Los Angeles, New York or Miami.
Additional information is available on the Netherlands' National Bureau for Tourism's Internet web site at http://www.goholland.com.
See our Foreign Entry Requirements brochure for more information on the Netherlands and other countries.
Visit the Embassy of the Netherlands web site at http://www.netherlands-embassy.org/homepage.asp for the most current visa information.
Information on work, residency and immigration requirements in the Netherlands can be found on the web site of the Dutch immigration authorities at www.ind.nl.

Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country; many borders are not staffed with officers carrying out this function.
If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry.
Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.

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

SAFETY AND SECURITY:
In 2004, the Dutch government implemented heightened security measures in response to concerns of international Islamic extremist terrorist activity on Dutch soil.
The November 2004 murder of Dutch filmmaker Theo van Gogh by an Islamic extremist in Amsterdam further increased concerns over Islamic extremist activity in the Netherlands.
One individual was arrested and later sentenced to life in prison for van Gogh's murder and related Islamic extremist activities.
Since the murder, the Dutch government has remained on heightened alert.

U.S. citizens in the Netherlands are encouraged to monitor media reports, and are reminded to maintain a high level of vigilance and to take appropriate steps to increase their security awareness.
As with other countries in the Schengen area, the Netherlands' open borders with its European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
Demonstrations are commonplace in the Netherlands and may range in number from a few people to several thousand.
Prior police approval is required for public demonstrations, and police oversight is routinely provided.
Nonetheless, situations may develop which could pose a threat to public safety.
U.S. citizens are advised to avoid areas in which public demonstrations are taking place.

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad.
CRIME:
While the rate of violent crime in the Netherlands is low, tourists are often targets of thieves.
Visitors frequently fall prey to pickpockets, bag snatchers and other petty burglars.
Theft from automobiles and hotel rooms are also on the rise.
Never leave baggage or other valuables unattended.

While thieves may operate anywhere, the U.S. Consulate General in Amsterdam receives frequent reports of thefts from specific areas.
Within Amsterdam, thieves are very active in and around train and tram stations, the city center and public transport.
More specifically, trains to and from Schiphol Airport are considered to be high risk, and theft of laptop computers has increased.
Thieves often work in pairs; one distracts the victim, often by asking for directions, while the accomplice moves in on the victim's momentarily unguarded handbag, backpack, laptop or briefcase.
The timing of these thefts usually coincides with train stops, enabling the thieves to escape.
In addition, many Americans have reported that their purses and briefcases have been stolen while eating in downtown restaurants, including hotel breakfast rooms.
A good rule of thumb is to never leave your personal items unattended when going to the restroom, buffet table, etc.

Confidence artists have victimized a number of Americans.
Typically, a U.S. citizen is notified via email of a winning lottery ticket, an inheritance, or other offer, which requires his/her assistance and cooperation to conclude.
The American is asked to forward advance payments for alleged"official expenses," "taxes," etc. and, often, to come to Amsterdam to conclude the operation.
Several Americans have lost tens of thousands of dollars in such scams.
Funds transferred in response to such offers cannot be recovered.
Information on fraud schemes can be found on the U.S. Embassy's web page.
For additional information, please contact the nearest office of the U.S. Secret Service or visit that agency's web site at www.secretservice.gov.
Additional information is also provided in the Department of State's pamphlet, Advance Fee Business Scams.
Travelers may also contact the Fraud Unit, Amsterdam Police, Police Headquarters, PB 2287, 1000 CG Amsterdam, Netherlands, tel. (31) (20) 559-2380, fax (31) (20) 559-5755.

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.
In the Netherlands, the U.S. Consulate General in Amsterdam provides all passport and American citizen services.
A lost or stolen passport can usually be replaced within a few hours during normal working hours for those with immediate travel plans.
If you are the victim of a crime while in the Netherlands, in addition to reporting to local police, please contact the U.S. Consulate General for assistance.
It is a good idea to make a photocopy of the "biographic page" of your passport, to bring extra passport photos, and to keep these separate from your actual passport just in case it is lost or stolen.
Consulate staff can, for example, help you 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.
Contact information is provided at the bottom of this document.

The Criminal Injuries Compensation Fund (CICF) of the Netherlands provides financial compensation, under specific circumstances, for victims of crime and for those who have suffered injuries and consequent loss caused by such incidents.
The fund also provides for dependents or immediate family members of homicide victims.
For more information, contact the Dutch Ministry of Justice at (31) (70) 414-2000.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical facilities are widely available.
Emergency medical response can be accessed by calling 1-1-2.
Reputable pharmacies are widely available and can assist with emergency prescription needs.
Some common medications are not available in the Netherlands without a prescription, and some prescription drugs cannot be mailed into the country.
Travelers are therefore urged to carry an adequate supply of prescription drugs in their original container while traveling.
Some U.S. over-the-counter medications are not available in the Netherlands and travelers should carry an adequate supply of these as well.
Those traveling with any preexisting medical problems should bring a letter from the attending physician, describing the medical condition and any prescription medications, including the generic name of prescribed drugs.

Vaccinations are not required for travel to the Netherlands.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's Internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Medical evacuations cost thousands of dollars and are not always covered by travel insurance.
Foreign doctors and hospitals usually require payment at the time service is rendered, and this too may not be covered by a traveler's policy.
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 Netherlands is provided for general reference only, and it may not be totally accurate in a particular location or circumstance:

Travel in, around, and between cities is possible via a highly advanced national train, light rail, tram, and bus network, by use of an extensive system of bike paths, and by automobile and motorcycle on the modern highway system.
Rail is often a convenient alternative to driving, particularly in the areas around Amsterdam, The Hague, and Rotterdam, where road congestion is frequent.
Rail network information is available at http://www.ns.nl.

Intercity travel by road is relatively safe in comparison with some other European countries.
Nonetheless, more than 1,000 people die and another 10,000 are injured in traffic accidents in the Netherlands each year.
More than two thirds of the fatal accidents occur outside urban areas.

A valid driver's license issued by a Department of Motor Vehicles in the U.S. is valid for use in the Netherlands for up to 180 days.
Seat belt and child seat use is compulsory.
Driving is on the right side of the road.
The maximum speed limit on highways is 120 km/h, with a highway speed limit of 100 km/h posted in most urban areas.
Secondary roads and some urban area highways have a speed limit of 80 km/h.
The speed limit in towns and cities is 50 km/h, with 30 km/h posted in residential areas.
The Dutch government has reduced speed limits on certain roads near cities in an effort to reduce air pollution.
During traffic jams, authorities also reduce speed limits; drivers should be sure to check for revised limits posted on electronic billboards above the highways.
Please note that drivers must yield the right-of-way to drivers and bikers coming from the right at intersections or traffic circles, unless otherwise posted.
The maximum allowable blood alcohol level in the Netherlands is 0.5 per mille.
The use of cellular telephones while driving is illegal without the use of a "hands-free" device.

Lanes at the center of many urban two-way streets are reserved for buses, trams and taxis.
In cities, pedestrians should be mindful of trams, which often cross or share bicycle and pedestrian paths.
Motorists must be especially mindful of the priority rights of bicyclists.
Pedestrians should not walk along bicycle paths, which are often on the sidewalk and usually designated by red pavement.
Travelers should also be watchful for one-way roads.

Taxi service in the Netherlands is safe but expensive.
Trams and buses are both convenient and economical, but often frequented by pickpockets.

Please refer to our Road Safety page for more information.
Visit the website of the Netherlands Bureau for Tourism at http://www.goholland.com.
Information also is available from the Netherlands Ministry of Transportation, Public Works and Water Management (Ministerie van Verkeer en Waterstraat) at http://www.minvenw.nl.

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

SPECIAL CIRCUMSTANCES:
Dutch customs authorities stringently enforce regulations concerning importation into the Netherlands of items such as firearms and other controlled materials.
Contact the Embassy of the Netherlands in Washington, D.C., or one of the Dutch consulates in Chicago, Houston, Los Angeles or New York for specific information regarding customs requirements.
Please see our Customs Information sheet.

Everyone age 14 and above is required to carry identification at all times while in the Netherlands.
Accepted forms of identification for U.S. citizens are either a Dutch residence card, issued by the Ministry of Foreign Affairs, or a U.S. passport.

U.S. citizens who obtain Dutch nationality may be required by the Dutch authorities to relinquish their U.S. citizenship.
For further information visit http://www.ind.nl/EN/verblijfwijzer/ and/or http://netherlands.usembassy.gov/dual_nationality.html.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the Netherlands are encouraged to register with the U.S. Consulate General through the State Department's travel registration website, and to obtain updated information on travel and security within the Netherlands.
Americans without Internet access may register directly with the U.S. Consulate General in Amsterdam.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency and to provide periodic information on issues of interest to American citizens.

The U.S. Embassy is located in The Hague, at Lange Voorhout 102; tel. (31) (70) 310-2209.
However, all requests for consular assistance should be directed to the Consulate General in Amsterdam at Museumplein 19, tel. (31) (20) 575-5309.
The after-hours emergency telephone number is (31) (70) 310-2209.
The U.S. Embassy and Consulate General web site at http://netherlands.usembassy.gov/ answers many questions of interest to Americans visiting or residing in the Netherlands.
*
*
*
This replaces the Consular Information Sheet dated June 28, 2006, to update the sections on Safety and Security and Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Thu, 25 Jul 2019 13:14:32 +0200

The Hague, July 25, 2019 (AFP) - Thousands of travellers flying to and from Amsterdam's Schiphol airport were met with another day of cancellations on Thursday. Dozens of flights were suspended after a malfunction in the kerosene refuelling system on Wednesday, which was later resolved.  But the disruptions went on to wreak further havoc on Thursday with Dutch airline KLM announcing it had cancelled 61 flights from Schiphol, one of the world's busiest transport hubs.   "We are restarting our operations gradually," a KLM spokeswoman told AFP.    The airport was not able to give an exact figure on the number of flight delays and cancellations.

On Wednesday night, around 300 flights from Amsterdam-Schiphol were cancelled due to a malfunction by the only company at the airport which supplies the fuel system, Aircraft Fuel Supply. Tens of thousands of passengers were affected with many stuck on aircrafts that were grounded.    Some travellers whose planes could not take off on Wednesday were forced to spend the night at the airport, a spokeswoman for Amsterdam-Schiphol said.
Date: Wed, 10 Jul 2019 15:47:59 +0200
By Jan HENNOP

The Hague, July 10, 2019 (AFP) - Millions of tiny caterpillars that shoot toxic hairs have triggered a health scare in the Netherlands, with hundreds of people seeking medical help for symptoms including severe skin irritation and asthma attacks.   The plague has caused at least two school closures and sporting event cancellations, prompting a meeting of Dutch agriculture officials on Wednesday to discuss how to dispose of them.

The problem has got so bad that an elderly Dutch woman in the town of Enschede attacked what she called the "rotten beasts" with a heat gun, in a video that has gone viral in the Netherlands.   "It's actually the first time that we're experiencing a plague of such proportions," Bastiaan Meerburg, director of the Dutch Pest and Wildlife Expertise Centre, told AFP.   "In some places, the caterpillars have more than tripled."    Complaints after coming into contact with the creature's venomous barbs, called setae, range from skin rashes and ugly blotches to shortness of breath and vomiting.

The infestation has become so bad that Dutch Agriculture Minister Carola Schouten ordered the creation of a government website to answer questions about the pesky crawlers.   It has more than 100 frequently asked questions ranging from what to do when pets come in contact with the hairs, to why the Dutch army is not being deployed to combat the infestation.   Two primary schools were temporarily closed near the port city of Rotterdam after pupils and teachers came into contact with the oak processionary caterpillars.

Hockey clubs in the central town of Veenendal meanwhile called off local tournaments due to nearby caterpillar nests.   The oak processionary caterpillar has always been in the Netherlands, but especially due to climate change it has proliferated and steadily made its way from the southern Limburg province to the north over the last two decades.   "The only places now not infested are the Wadden Islands, which lies off the northern Dutch coast," said Meerburg.

More oak trees have also been planted over recent years, while experts also believe a decline in the caterpillars' natural enemies like other predatory insects may have played a role.   There is however some relief on the horizon: by mid-July the caterpillars are expected to go into cocoons to become moths, meaning no more creepy crawlies capable of producing a million microscopic hairs over two months.   But the nests and the hairs -- which can last for up to seven years and withstand temperatures of up to 600 degrees Celsius -- remain and needed to be removed by being sucked up with a special industrial vacuum cleaner.   "It's a problem that's not going to go away," said Meerburg.
Date: Tue, 25 Jun 2019 15:49:33 +0200

The Hague, June 25, 2019 (AFP) - Dutch health authorities said Tuesday they are dealing with a measles outbreak in a devout Protestant fishing village where vaccination rates are among the lowest in the country.   Nine children and one adult have been diagnosed with the disease in the village of Urk, part of the so-called "Bible Belt" in the northern Netherlands, the Flevoland province health service said.

The health service said it was "actively monitoring the situation" and examining whether it was necessary to vaccinate or administer antibodies to people who have been in contact with the infected patients.   "In 2013 and previously, the disease occurred more often on Urk. Many people on Urk have experienced this disease and that means that a natural defence has built up," it said.   Only 61.1 percent of people are vaccinated against measles in Urk, one of the lowest rates in the Netherlands, where the national average is 92.9 percent, according to the National Public Health and Environment Institute.

Urk is regarded as one of the most devout of the villages in the "Bible Belt" of conservative Protestant communities running from Zeeland in the south of the Netherlands across the country to the north west.   Ninety-four percent of people in Urk regularly go to church, according to the Dutch Central Bureau of Statistics, compared to one in six of all Dutch people.

Dutch newspaper De Telegraaf said that in this devout community of Urk people believe that life and death are in God's hands, and so vaccinations are not permitted.   Urk is considered a "closed' community because of its fisheries culture and Protestant orthodox religion," a European Commission report from 2010 said.

The UN warned in April of a global resurgence of measles -- a highly contagious viral infection that can prove fatal -- amid a growing "anti-vax" movement worldwide.   The WHO says cases of the once all-but-eradicated disease surged 300 percent in 2018 across the globe.   The anti-vax phenomenon has adherents across Western countries but especially in the United States, where it has been fuelled by the spread on social media of claims that the jab could cause autism, which medical officials have found are baseless.
Date: Tue, 28 May 2019 11:27:14 +0200

The Hague, May 28, 2019 (AFP) - A strike by public transport workers in the Netherlands forced the cancellation of dozens of flights at the country's main airport on Tuesday as passengers faced difficulties reaching the airport.   "Several airlines cancelled their flights," said Willemeike Koster, spokeswoman of Amsterdam's Schiphol airport.

Dutch carrier KLM, along with budget airlines Ryanair and EasyJet, were among the airlines cancelling some 80 flights overall. Several other flights were delayed.   "It's busy on the roads to the airport due to the strike because there is very limited train traffic between Schiphol and Amsterdam," she said. "There are four trains per hour today instead of the usual 25."

Once passengers reach the airport, services are functioning normally, she added.   Dutch trade unions called the strike to secure better pension benefits and to call for the country's retirement age to be fixed at 66 years.   The FNV, the largest trade union in the Netherlands, also plans for brief strike actions among security and cleaning staff at Schiphol airport on Wednesday.
Date: Sun, 26 May 2019 18:19:48 +0200

The Hague, May 26, 2019 (AFP) - A Dutch judge Sunday ruled against plans by the country's largest trade union to allow train drivers serving Amsterdam's busy Schiphol airport to join a country-wide strike.   Thousands of bus, train and tram drivers are expected strike on Tuesday in
protest at government plans to raise the retirement age from 66 and to demand higher pension payments.

"Our right to call a 24-hour strike remains, with the exception of a limited number of trains running to and from Schiphol," the FNV union said in a statement.   "There will be four trains an hour between Schiphol and Amsterdam Central station... in order to guarantee public order at the airport," the FNV said.   Last year, Schiphol was Europe's third-busiest airport with 71.5 million passengers, behind London Heathrow and Paris-Charles de Gaulle, according to figures by the Airports Council International Europe (ACI).   Apart from being the gateway to Amsterdam, Schiphol is also a major transit hub for flights from all around the globe.

The decision by the judge comes after negotiations between Schiphol Airport's management and the FNV broke down earlier on Sunday "despite intensive talks," the FNV said.   Schiphol, in a statement, warned of "traffic congestion, limited train access and no buses" during Tuesday's strike.   "If you're travelling to or from Schiphol Airport on 28 May, please note that travelling by train is limited and trains and stations will be crowded," the airport said.   Although no figures re available, FNV spokeswoman Mariette van Dijk told AFP that "thousands of bus, train and tram drivers, as well as ferry boat captains" were expected to join the strike.

Tuesday's day-long strike follows similar industrial action in March, when public transport was shut down for 66 minutes -- symbolic of the current retirement age.   But the government led by business-friendly Dutch Prime Minister Mark Rutte's Liberal VVD party accelerated plans to increase the retirement age to 67 years in 2021 and 67 years and three months in 2022.   "People are healthier and they live longer," the Dutch government said on its pensions website.   "The higher life expectancy makes working for longer and a gradual increase in the state pension age possible," the Dutch government said.
More ...

World Travel News Headlines

Date: Wed, 21 Aug 2019 18:28:15 +0200 (METDST)

Abuja, Aug 21, 2019 (AFP) - Nigeria on Wednesday announced that three years had elapsed since it last recorded a case of polio, a key step towards eradicating the notorious disease in Africa.    "Three years without a case of wild polio virus is a historic milestone for Nigeria and the global community," said Faisal Shuaib, director of the National Primary Health Care Development Agency.   Nigeria, Africa's most populous nation, was the last country on the continent to suffer from outbreaks of the wild polio virus, but has recorded none since August 2016. 

The West African giant will submit data on its polio cases to the World Health Organization (WHO) in March 2020, a move that could pave the way for the whole of the continent to be declared free of the virus.   "If the data confirms zero cases, the entire African region could be polio-free by middle of next year," the WHO representative in Nigeria, Clement Peter, said.    The poliovirus infects the brain and spinal cord, potentially causing lasting muscle pain, weakness or paralysis.    The virus only infects humans, with young children highly vulnerable.   It is transmitted through contact with the faeces of infected individuals, such as through unsanitary water or food.   It has no cure but can be prevented through immunisation.

Only Pakistan and Afghanistan are still battling incidents of the disease around the world.   The fight against the virus in Nigeria was slowed by the Boko Haram insurgency that has torn apart the northeast of the country over the past decade.    The insecurity, which has displaced more than two million people, hampered vaccinations in the region and prevented access to people in remote areas.    While fighting jihadists, Nigeria and neighbouring countries in the Lake Chad Basin have held polio vaccination campaigns to prevent the spread of the virus.

Once a worldwide scourge, the number of cases around the globe have fallen by more than 99 per cent since 1988, according to the WHO.   In 2012, Nigeria had 122 polio sufferers, more than half of the 223 victims worldwide.   Despite the progress, aid organisations warned there could be no letup.   "The battle is not over yet," Pernille Ironside, Unicef's deputy representative for Nigeria, said.    "We have to maintain our effort and intensify them to make sure the historic gains are sustained."
Date: Tue, 20 Aug 2019 23:46:29 +0200 (METDST)

Los Angeles, Aug 20, 2019 (AFP) - The jam-band Phish announced Tuesday that plague-infected -- yes, that plague -- prairie dog colonies had forced the cancellation of overnight camping and vending for its annual concert series near Denver.   The band will still play over the Labor Day holiday weekend but said in a statement that health officials overseeing Colorado's Rocky Mountain Arsenal National Wildlife Refuge urged precautionary measures like restricting parking and camping to prevent potential spread of the disease.   "We recognize the tremendous inconvenience this may cause for those who had planned on camping," said Phish, a rock band known for its improvisation and hardcore fan base.   Officials had closed parts of the 15,000-acre refuge starting in July, a statement from the US Fish & Wildlife Service said. Some were re-opened in recent days but several trails remain closed.   Today the plague can be treated with antibiotics but is best known for killing 60 percent of Europe's population during the Black Death of the Middle Ages.

The last epidemic in the United States was in the 1920s in Los Angeles.   Humans can contract the easily spreadable plague from fleas that transmit it from infected rodents, as well as from coming into contact with infected bodily fluids or by inhaling coughed-up bacteria.  

Many dedicated Phish fans had decried the lack of information concerning the August 30-September 1 concerts in the lead-up to Tuesday's announcement: "People are already changing their plans. People are mad," fan Keegan Lauer told a local CNN affiliate of the confusion.   "People are Phish fans and Phish fans that are mad are really mad."
Date: Tue, 20 Aug 2019 23:40:37 +0200 (METDST)

Madrid, Aug 20, 2019 (AFP) - Unions representing Ryanair cabin crew in Spain warned on Tuesday of a 10-day strike in September to protest against the anticipated closing of some airport bases for the low-cast Irish airline.   After meeting with Ryanair representatives for more than seven hours, "which ended without an accord," the unions USO and Sitcpla issued a warning of a strike at 13 Ryanair bases in Spain, the USO said in a statement.   It said the protest was over the possible closing of Ryanair bases at airports on the popular tourist Canary islands of Tenerife and Gran Canaria and also the "future uncertainty" for Girona in northeast Spain.   More meetings between unions and Ryanair management could be held next week, USO said.   Cabin crew are set to observe the strike mainly on Fridays and Sundays in September.

Ryanair had announced last month that it would close some bases because of problems with Boeing's crisis-hit 737 MAX jet, which has been grounded after two fatal accidents.   The Irish no-frills airline said it expected to take delivery of just 30 Boeing 737 MAX 200 jets by the end of May 2020, instead of the 58 that it originally expected, and shortfall would mean it would have to close some bases.   Ryanair also announced in July that it intends to eliminate 900 jobs in its 13,000-strong workforce, and it has faced several protests by employees in Europe.   Pilots in the UK and Ireland warned of strikes in August and September to protest against their working conditions and salaries.
Date: Tue, 20 Aug 2019 15:45:49 +0200 (METDST)

Madrid, Aug 20, 2019 (AFP) - A 90-year-old woman has died and 53 people are in hospital in Spain, including several pregnant women, after eating contaminated meatloaf, officials said Tuesday.   Listeria is a commonly found bacteria and most people who consume foods that contain it do not become ill.  But for elderly people, pregnant women or those with serious conditions like diabetes or cancer, it poses a serious threat.   The outbreak of listeria is affecting mainly the southwestern region of Andalusia where 114 cases have been confirmed, according to the regional health department.

Outside Andalusia, only one case has so far been confirmed in the neighbouring region of Extremadura, Spain's Health Minister Maria Luisa Carcedo told Cadena Ser radio.   A 90-year-old patient affected by the outbreak died overnight at a hospital in Seville, the capital of Andalusia, the regional government said in a statement.   It said another 53 people are in hospital including 18 pregnant women and two new-borns.

Spanish consumer group Facua said two pregnant women who ate meatloaf, suspected of being contaminated with listeria, "lost their babies" in Seville.   An investigation has been opened because there appears to be a link to the outbreak of listeria, the health ministry said.   The regional government of Andalusia warned last Thursday that meatloaf sold under the commercial name "la Mecha" made by Seville-based company Magrudis was the source of a listeria outbreak.   The factory was closed and all of its meatloaves were recalled from shops, the health ministry said.   Listeriosis begins with flu-like symptoms including chills, fever and muscle aches. It can take up to six weeks after consuming contaminated foods for symptoms to occur.
Date: Tue 20 Aug 2019
Source: WTOP [edited]

Health authorities in Spain are on high alert after a 90 year old woman died amid a listeria outbreak in the southern region of Andalusia that has affected more than 110 people.

Jose Miguel Cisneros, director of the infectious disease department at Seville's Virgen del Rocio Hospital, on Tuesday [20 Aug 2019] announced the 1st casualty since the outbreak was declared on 15 Aug [2019]. Authorities have closed the pork meat supplier's plant and recalled all of its products. Cisneros said roughly half of the 114 people affected by the bacteria remain hospitalized.

Health minister Maria Luisa Carcedo said an investigation is looking into how the meat evaded what she called "strict food safety controls".

Listeria is a bacteria that usually causes mild illness in healthy people but can be dangerous to pregnant women and those with weakened immune systems.
======================
[The listeriosis outbreak, which was previously reported to have affected 44 people mainly in the cities of Huelva and Seville (ProMED-mail post Listeriosis - Europe (06): (Spain) meat, recall, alert http://promedmail.org/post/20190817.6627473), is now said to involve 114 people.

Huelva, with a population of 144,258 residents, is a city located along the Gulf of Cadiz coast in south western Spain in the autonomous community of Andalusia (<https://en.wikipedia.org/wiki/Huelva>). Seville, with a metropolitan population of about 1.5 million, is the capital and largest city of the autonomous community of Andalusia, located about 80 km (50 mi) inland from the Gulf of Cadiz coast (<https://en.wikipedia.org/wiki/Seville>).

A map showing the location of Huelva and Seville can be found at

We still have not been told the characteristics of the meat product involved in this listeriosis outbreak. Adequate cooking of the meat before eating should have markedly reduced the risk for listeriosis. However, refrigerated ready-to-eat cold cut meats are well-recognized sources for listeriosis. Even if initial contamination added only a few listeria organisms to the food, the contamination can be significant for refrigerated foods because _Listeria monocytogenes_ can subsequently multiply at refrigerator temperatures to sufficient number to cause disease. Refrigerated ready-to-eat meat products should not be served to people who are likely to be at increased risk for listeriosis, such as pregnant women, adults aged 65 years or older, and people with weakened immune systems.

The meat ("La Mecha" made by the Magrudis company, based in Seville) suspected to be the source has been recalled, but because it can take up to 70 days after exposure to listeria for symptoms of listeriosis to develop, more cases can be expected.

In the USA and Europe, clusters of related cases are identified based on clinical isolates of _L. monocytogenes_ that have similar genotypes. Food is confirmed to be the source if listeria isolated from it has a genotype that matches the genotype of the clinical outbreak strain. We await further developments in the investigation of this outbreak. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Spain:
Date: Mon 19 Aug 2019
Source: ARY News [edited]

One more case of Congo virus [has been] reported in Karachi as a young boy was diagnosed with the disease after being admitted at a hospital in Nazimabad area, ARY News reported on Sunday [18 Aug 2019]. Doctors confirmed that the 17 year old boy, named as [QS] who is [a] resident of Sohrab Goth and worked at a dairy farm, was diagnosed with Congo virus during the initial medical examination tests.

It is pertinent to mention here that the 1st case of Congo virus was reported on [11 Feb 2019] in the metropolis as a woman, [TF], [who] had been brought to Jinnah Hospital in critical condition.

In 2018, at least 16 deaths were reported in Karachi from the life-threatening virus, and 41 patients -- mainly from Quetta, Balochistan -- were diagnosed with it.

Earlier on [25 Jul 2019], a Congo virus alert had been issued for the metropolis, stipulating precautionary instructions for all those people who visit cattle farms. The alert was issued by Karachi Metropolitan Corporation (KMC) to hospitals, directing the management to adopt special precautions for a Congo-affected patient. The letter of the KMC further asked hospitals to establish special wards for Congo patients, and run awareness campaigns about the virus through banners and posters.

The disease is caused when a tick attaches itself to the skin of cattle, and when that infected tick or animal comes in contact with people, the highly contagious virus is transmitted into the human body and the person falls ill. This disease has a 40% to 50% mortality rate. The initial symptoms of Congo fever include headache, high fever, rashes, back pain, joint pain, stomach pain and vomiting.

Precautions: people should wear light-coloured and airy clothes while going to cattle farms. Use of mask and gloves is also recommended while touching animals.
Date: Wed 21 Aug 2019
Source: The Canberra Times [edited]

Australian Capital Territory (ACT) health officials are investigating a cluster of hepatitis A cases in Canberra's South Korean community. There have been 8 cases of the virus in the ACT and Sydney since June 2019. The cluster of cases comes as South Korea experiences a large outbreak of the virus, with more than 11,000 cases reported in the country in 2019.

ACT Health said it was working with its counterparts in New South Wales to investigate the cause of the outbreak. An ACT Health spokesman said most of the people affected by hepatitis A in recent weeks in Canberra had not reported travelling overseas recently. "Australia has a low incidence of hepatitis A, and when outbreaks occur, they are linked to consumption of contaminated food products or person-to-person spread," the spokesperson said. "However, at this stage of the investigation, no specific food has been connected to the outbreak."

Symptoms of the virus may include nausea, vomiting, fever and yellowing of the skin, dark urine and pale stools.

"The ACT Health directorate is reminding the South Korean community in Canberra and anyone travelling to South Korea, of the importance of vaccination prior to travel and practicing good hand hygiene to reduce the risk of spread," the spokesman said. Health officials have recommended at least one dose of a hepatitis A vaccination before travel. Two doses prevent an infection.

Handwashing in soap and water for at least 15 seconds has also been recommended by health officials to help prevent the spread of the virus.
===================
[Since no travel was involved, it is not clear if the cases were from imported food, food contaminated by an infected food handler or from transmission from an asymptomatic person. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Australia:
Date: Tue 20 Aug 2019, 4:29 PM
Source: Arka News Agency [edited]

Anthrax cases have been reported in Geghhovit community of Armenia's Gegharkunik province, the press office of Armenia's health ministry reported on [Tue 20 Aug 2019]. According to the ministry's press release, 2 residents of the community came to a medical centre in Martuni with sores on their fingers. The patients told doctors that they had taken part in butchering a cow of a fellow villager.

The health ministry has dispatched its experts to the community. As a result of joint efforts with local medical centres' workers, 6 other infected people have been found. All the patients are being treated now, and the community is under medical control now. The Armenian Food Safety Agency has been informed.
===================
[Gegharkunik province is on the eastern border of Armenia and pokes into Azerbaijan; see:
<http://legacy.lib.utexas.edu/maps/commonwealth/armenia_pol_2002.jpg>

Geghhovit is south of Sevana Lich (lake); see:

When the dust settled there were 2 initial cutaneous cases subsequent to them butchering a neighbour's cow, which would have been sick or dead. The first report suggests that they might have butchered a number of "cattle" carcasses, though the 2nd report has a single cow. And in due course another 6 villagers came down with cutaneous anthrax as they were sent to the local hospital merely for diagnostic confirmation.

Anthrax is sporadic in Armenia and thus the risks of butchering sick and dead animals are only realised after the onset of human anthrax lesions. And the number of human cases can exceed the indirectly reported livestock cases. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Date: Mon 19 Aug 2019
Source: Centers for Disease Control and Prevention (CDC) [edited]

Viral hepatitis, outbreaks, hepatitis A outbreaks
-------------------------------------------------
Since March 2017, CDC's Division of Viral Hepatitis (DVH) has been assisting multiple state and local health departments with hepatitis A outbreaks, spread through person-to-person contact.

The hepatitis A vaccine is the best way to prevent HAV infection.

The following groups are at highest risk for acquiring HAV infection or developing serious complications from HAV infection in these outbreaks and should be offered the hepatitis A vaccine in order to prevent or control an outbreak:
- people who use drugs (injection or non-injection);
- people experiencing unstable housing or homelessness;
- men who have sex with men (MSM);
- people who are currently or were recently incarcerated; and
- people with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C.

One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A and provides up to 95% seroprotection in healthy individuals for up to 11 years.

Pre-vaccination serologic testing is not required to administer hepatitis A vaccine. Vaccinations should not be postponed if vaccination history cannot be obtained or records are unavailable.
[further information available at URL above]
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[Overall, the top 4 states for HAV cases remain Kentucky, Ohio, Florida and West Virginia.

As the numbers of cases continue to raise in a number of states, and news of smaller (so far) outbreaks occur in others, the question at the end of ProMED-mail post http://promedmail.org/post/20190104.6241686 by a Kentucky official -- "This is a disease of developing countries. One has to ask: Why are we seeing it in the USA?" -- is more and more relevant. We are seeing these outbreaks because of the inability to deal with marginalized populations among our midst. The dramatic cutbacks in public health infrastructure in some of these states clearly feed the fire of these outbreaks. They must be addressed by bolstering public health resources and education and directly addressing the needs of these marginalized populations. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Fri 16 Aug 2019
Source: Fox News [edited]

A 7 year old girl from Mt Vernon, Ohio has been infected with a rare mosquito borne virus that, in severe cases, can cause encephalitis, or an inflammation of the brain. The girl, who was not identified, has been confirmed to have La Crosse virus (LACV), local news outlet Knox Pages reported, citing the Knox County Health Department. It wasn't immediately clear where or when the girl was infected.

La Crosse virus is typically caused by a bite from an infected eastern tree-hole mosquito [_Aedes triseriatus_], which "lays its eggs in tree holes and man-made containers" and "typically bites during the day", according to the Centers for Disease Control and Prevention (CDC).

A rare disease -- there is an average of 70 cases in the United States each year, according to the federal health agency -- LACV can make a person feel ill with fever, headache, nausea, vomiting, and fatigue. Most people begin to notice symptoms 5 to 15 days after they are bitten. In severe cases, however, LACV can lead to encephalitis -- though this is commoner in children under 16 "and is often accompanied by seizures," says CDC. "Coma and paralysis occur in some cases," it added.

The disease is diagnosed through blood and spinal fluid tests. There's no specific treatment for the mosquitoborne ailment. "Antibiotics are not effective against viruses, and no effective anti-viral drugs have been discovered. Severe illnesses are treated by supportive therapy which may include hospitalization, respiratory support, IV fluids, and prevention of other infections," CDC added, noting that most people infected make a full recovery.

People are most at risk for LACV if they live in wooded areas. Most cases in the US have occurred in upper Midwestern, mid-Atlantic and southwestern [sic. southeastern] states. Ohio, specifically, sees about 20 cases of the disease each year, according to the Knox Pages.

The best way to prevent LACV and other mosquitoborne ailments is by draining standing water -- like in birdbaths, buckets or on pool covers -- which can serve as a breeding ground for these insects. Other preventative measures include covering skin with long-sleeved pants and shirts while outside and using insect repellent containing DEET or another EPA-recognized ingredient.  [byline: Madeline Farber]
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[The previous case of La Crosse virus encephalitis in Ohio was in a boy, also 7 years old. Severe neurological cases of La Crosse virus encephalitis mainly occur in pre-school age children. They are seldom fatal, but prolonged hospitalization and sequelae including personality changes, may occur.

As noted earlier, La Crosse encephalitis virus (LACV) is a member of the California serogroup of arboviruses. A map of the distribution of California virus serogroup neuroinvasive disease cases (mainly LACV cases) shows 3 major focal geographic areas: (1) in the unglaciated areas of south eastern Minnesota/south western Wisconsin/north western Illinois, (2) Ohio, where this case occurred, and (3) the central Appalachian Mountain areas of Virginia/West Virginia and North Carolina/Tennessee, (see the CDC map at <http://www.cdc.gov/lac/tech/epi.html>).

Cases may occur earlier in the summer season than other arthropod-borne viruses because the virus can be transovarially transmitted by the infected female to her eggs, so that emerging adults may already be infected and ready to transmit the virus without the need to take an infectious blood meal from an infected forest mammal. It is wise to eliminate fresh water catchments, which are breeding sites of _Aedes triseriatus_, the La Crosse virus vector mosquito. The Asian tiger mosquito _Aedes albopictus_ can also transmit the virus.

The CDC has a good summary of LACV, its epidemiology, geographic distribution, and clinical characteristics at

An image of _Aedes triseriatus_ can be seen at

[HealthMap/ProMED map available at:
Ohio, United States: <http://healthmap.org/promed/p/237>]