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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our information on medical insurance overseas.

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

New Zealand

New Zealand US Consular Information Sheet
September 22, 2008
COUNTRY DESCRIPTION:
New Zealand is a highly developed, stable parliamentary democracy, which recognizes the British monarch as sovereign. It has a modern economy, and tourist fa
ilities are widely available. The New Zealand Tourist Board, which has a wide range of information of interest to travelers, can be contacted via the internet at http://www.newzealand.com/USA/.
Read the Department of State Background Note on New Zealand for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. citizens eligible for a visa waiver do not need a visa for tourist stays of three months or less. For more information about visa waivers and entry requirements, contact the Embassy of New Zealand: 37 Observatory Circle NW, Washington, DC 20008, telephone (202) 328-4800; or the Consulate General of New Zealand in Los Angeles: 2425 Olympic Blvd Suite 600E, Santa Monica, CA 90404, telephone (310) 566-6555.
Visit the Consulate of New Zealand web site at http://www.nzcgla.com for the most current visa information.

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

SAFETY AND SECURITY:
U.S. citizens in New Zealand should review their personal security practices, be alert to any unusual activity around their homes or businesses, and report any significant incidents to local police.

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 other callers, 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 personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves overseas, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Crime rates in New Zealand are low but have increased in recent years. The most prevalent crime is theft or attempted theft from cars, camper vans and hostels. To help protect against theft, do not leave passports, or other valuable items in unattended vehicles. Violent crime against tourists is unusual; however, visitors who are traveling alone should be especially vigilant, and avoid isolated areas that are not frequented by the public.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
In New Zealand, a private organization called Victim Support works both independently and with the NZ Police to assist victims of crime. Victim Support is available 24 hours per day on 0800-842-846, 0800-Victim, by email at victim@xtra.co.nz.

The local equivalent to the “911” emergency line in New Zealand is 111.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Quality medical care is widely available, but waiting lists exist for certain types of treatment.
High-quality medication (both over-the-counter and prescription) is widely available at local pharmacies, though the products’ names may differ from the American versions.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Doctors and hospitals often expect immediate cash payment for health services.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); fax 1-888-CDC-FAXX (1-888-232-3299), 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/.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of New Zealand.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning New Zealand is provided for general reference only.

All traffic travels on the left in New Zealand, and drivers should exercise extra caution if accustomed to driving on the right. Driving on the wrong side of the road is a leading cause of serious injury and death for American tourists.
Cars turning left must yield to oncoming cars that are turning right.
Proceed carefully through intersections.
Red means “stop”—do not turn at a red light.

New Zealand has only 100 miles of multilane divided motorways. Most intercity travel is accomplished on two lane roads.
While these are in good condition, New Zealand's rugged terrain means motorists often encounter sharper curves and steeper grades than those found in the U.S. interstate highway system. Renting a car or camper is a popular way to enjoy New Zealand's natural beauty, but visitors unfamiliar with local conditions should drive particularly conservatively.
Posted speed limit signs should be observed. Drivers should use caution to avoid animals when driving in rural areas.

Pedestrians are advised to look carefully in all directions before crossing a street or roadway, and to use crosswalks.
Pedestrians do not have the right of way except in crosswalks.
New Zealand law requires that cars yield to pedestrians in a crosswalk, and that cars stop at least two meters (approximately 6 feet) from a crosswalk that is in use.

Traffic circles are common throughout New Zealand.
When approaching a traffic circle, always yield to traffic coming from the right –noting that traffic already in the circle has the right-of-way-- and merge to the left into the circle.

Public transportation, including buses, trains and taxis, is for the most part reliable and safe.
In case of emergency, phone the local police at 111.

Please refer to our Road Safety page for more information.
For specific information concerning the operation and rental of motor vehicles, contact the New Zealand Tourist Board via the Internet at http://www.newzealand.com/USA/ or the Land Transport Safety Authority at http://www.ltsa.govt.nz.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of New Zealand’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of New Zealand’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:
Some heavily populated parts of New Zealand are in areas of very high seismic activity. General information regarding disaster preparedness is available from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.

Many tourists come to New Zealand to participate in extreme adventure sports, such as bungee jumping, sky diving, hiking, rappelling, climbing, motorcycling, and kayaking.
All too often, injuries and even death result from participation in such activities.
Travelers are advised to employ caution and common sense when engaging in adventure sports.
Never participate in such sports alone, always carry identification, and let someone else know where you are at all times.
Before kayaking, check the river conditions and wear a life jacket.
When hiking, rappelling, or climbing, carry a first aid kit, know the location of the nearest rescue center, and bring a friend along.

New Zealand is an island nation, and the government is serious about preserving its delicate ecosystem.
The Ministry of Agriculture and Forestry (MAF) imposes strict regulations regarding what can be imported into New Zealand.
People failing to declare goods that could be quarantined can be fined up to $100,000 NZ and/or face up to five years in prison. People failing to declare risk goods such as fresh fruit, seeds, and plants can receive an instant fine of $200 NZ.
When importing a pet, thorough veterinary documentation and a quarantine period are required.
Unfinished wood products, used hiking shoes and gardening tools, fresh food items, and items such as used pet carriers may be seized and destroyed by MAF.
More information can be found at http://www.biosecurity.govt.nz/personal-travel-belongings-and-mail/arriving-by-air/what-you-cannot-bring
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 those in the United States for similar offenses.
Persons violating New Zealand laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs in New Zealand are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in New Zealand are encouraged to register with the nearest U.S. embassy or consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within New Zealand.
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 in Wellington is located at 29 Fitzherbert Terrace, Thorndon, Wellington.
The telephone number is (64) (4) 462-6000.
The fax number is (64) (4) 471-2380.
The Embassy’s web site is http://wellington.usembassy.gov.
The U.S. Embassy in Wellington does not have a consular section and thus cannot provide consular services to American citizens.
All consular services for American citizens are provided by the Consulate General in Auckland.
The U.S. Consulate General in Auckland is located on the third floor of the Citigroup Centre, 23 Customs Street East, between Commerce and Queen Streets. The telephone number is (64) (9) 303-2724. The fax number is (64) (9) 366-0870.
See information on services to Americans at http://wellington.usembassy.gov/service.html.
The Consulate General in Auckland handles all consular matters in New Zealand.

For after-hours emergencies anywhere in New Zealand, a duty officer can be contacted by telephone. Persons seeking after-hours assistance may call (64) (4) 462-6000; after listening to a brief recording, the caller may leave a message on the voice mail system, describing the nature of the emergency and giving a point of contact. The phone system will automatically call the duty officer in Wellington or in Auckland, who will listen to the message and take the appropriate action .
*

*

*
This replaces the Country Specific Information dated January 31, 2008, to update the Information for Victims of Crime, Medical Facilities and Health Information sections.

Travel News Headlines WORLD NEWS

Date: Wed, 5 Feb 2020 02:27:15 +0100 (MET)

Wellington, Feb 5, 2020 (AFP) - Severe flooding forced thousands of residents in New Zealand's South Island to flee their homes on Wednesday and left hundreds of tourists stranded at the remote Milford Sound beauty spot.   The Southland region declared a state of emergency after being deluged with more than 1,000 mm of rainfall in 60 hours, triggering landslides on major roads and causing rivers to burst their banks.

Authorities told residents in the low-lying areas of Gore and Mataura to evacuate immediately early on Wednesday as floodwaters in the Mataura river peaked, warning those further downstream in Wyndham to prepare to leave.   "We have issued notices to evacuate and to prepare to evacuate to 6,000 people across the region," an Emergency Management Southland (EMS) spokeswoman told AFP.

Residents were advised to grab medication, clothing and identification documents, then head to higher ground.   Power to affected areas was cut off as a precaution and evacuation centres were set up in local churches and schools.

Floodwaters washed away sections of the only road to Milford Sound, a popular hiking spot for international tourists, and EMS said almost 200 people were being airlifted to nearby Te Anau.   "The tourists... have been well catered for," it said.   "Morale has been high amongst the visitors and staff, as they received regular briefings and have been in contact with friends and family."   Only two minor injuries have been reported after a landslide hit a hut on the Routeburn walking track, with both people receiving treatment at the scene.
Date: Fri 24 Jan 2020
Source: Stuff [abridged, edited]

Authorities have sounded the alarm after a passenger infected with measles flew from Auckland to Tonga [and returned] in recent days.

People who were on the flights should be on guard for signs of the highly infectious disease, Auckland Regional Public Health Service (ARPHS) medical officer of health Maria Poynter said.

The same measles patient flew from Auckland to Tonga and back over 2 days.

[See URL for flights.]
Date: Wed 8 Jan 2020
Source: Stuff [abridged, edited]

More than 2400 people travelling on the Interislander over the holidays may have been exposed to measles. A child, whose family had chosen not to vaccinate, likely contracted the measles in Auckland, then crossed Cook Strait on the Interislander's Kaitaki ferry twice during the holiday period.

There were 1219 passengers on the 1st crossing and 1220 passengers on the 2nd. KiwiRail, which runs the Interislander, became aware of the issue after the Canterbury District Health Board (CDHB) publicly notified the case on Tuesday [7 Jan 2020].

The CDHB urged people who had not been vaccinated and may have come into contact with the child to isolate themselves. "We are contacting all passengers and crew who travelled on the 2 affected sailings to provide health advice from the Canterbury District Health Board," KiwiRail tourism and marketing executive general manager Ahleen Rayner said.  [See URL above for locations, dates of possible exposure.]  [Byline: Oliver Lewis]
Date: Fri 27 Dec 2019
Source: NZ Herald [abridged, edited]

A total of 7 new cases of measles have been confirmed in Hawke's Bay in the past 2 weeks, taking the total to 26 for the year [2019]. Hawke's Bay District Health Board Medical Officer of Health Dr. Rachel Eyre said the new cases were linked to an infant too young to be immunised, who had been hospitalised recently.

"Public health has worked hard over the Christmas break to identify other close contacts to identify those not immune (protected against measles) because of the high likelihood they could get it too," she said. Dr. Eyre said, as the cases were all closely linked, any risk to the wider general public was low.  [Byline: Christian Fuller]
Date: Fri, 13 Dec 2019 05:24:44 +0100 (MET)
By Neil SANDS

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

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

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

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

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

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

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

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

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

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

Cayman Islands

CAYMAN ISLANDS US Consular Information Sheet
October 02, 2008

COUNTRY DESCRIPTION:
The Cayman Islands are a British dependent territory consisting of three main islands with a total area of approximately 100 square miles and located a
out 500 miles west of Jamaica. There is an international airport located in Grand Cayman, and facilities for tourists are widely available. The U.S. Embassy in Kingston, Jamaica, has consular responsibility for the Cayman Islands. Read the Department of State Background Notes on the Cayman Islands for additional information.

ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside of the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed-loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other Western Hemisphere Travel Initiative (WHTI) compliant document such as a passport card for entry or re-entry to the U.S. Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.
Applications for the new U.S. Passport Card are now being accepted and have been in full production since July 2008.The card may not be used to travel by air and is available only to U.S. citizens. Further information on passport cards is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.
Visas are not required for U.S. citizens traveling to the Cayman Islands for short-term visits. U.S. citizens traveling to the Cayman Islands for work must obtain a temporary work permit from the Department of Immigration of the Cayman Islands, telephone (345) 949-8344. There is a departure tax for travelers age 12 and older, which is regularly included in airfare. For further information travelers may contact Cayman Islands Department of Tourism offices in Miami at (305) 599-9033, New York (212) 889-9009, Houston (713) 461-1317 and Chicago (630) 705-0650; or via the Internet at http://www.caymanislands.ky.

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 Cayman Islands are considered politically stable and enjoy a high standard of living. There have been no reported incidences of terrorism or threats made against Americans or American interests in the Cayman Islands.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for other callers, 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 pamphletA Safe Trip Abroad.
CRIME: The crime threat in Cayman Islands is generally considered low, although travelers should always take normal precautions when in unfamiliar surroundings. Petty theft, pick-pocketing and purse snatchings occur. A few cases involving sexual assault have been reported to the Embassy. Police in the Cayman Islands rigorously enforce laws against illegal drugs. The majority of arrests of American citizens in the Cayman Islands over the past two years have been for possession, consumption, or intent to sell marijuana, cocaine or other illicit drugs. American citizens should avoid buying, selling, holding or taking illegal drugs under any circumstances.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in the Cayman Islands is “911.”
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: The quality of medical care in the Cayman Islands is generally comparable to that available in the United States; however, some procedures and cases requiring critical care may require medical evacuation to the United States. Several American citizens each year drown or suffer cardiac arrest while snorkeling or scuba diving in the Cayman Islands. These deaths may be attributed in part to tourists attempting to do more than they are trained to do or to poor physical conditioning or preexisting medical conditions that are exacerbated when snorkeling or diving. A hyperbaric chamber is available for treatment of decompression illness. Doctors and hospitals often expect immediate payment for health services.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

Although there are no express HIV/AIDS entry restrictions exist for visitors to the Cayman Islands, persons suffering from HIV/AIDS can be denied permission to land if a Health Officer certifies that their entry to the Islands would be dangerous to the community pursuant to Section 82 (c) of the Cayman Immigration Law (2007 Revision), which states:

“The following persons, not being Caymanian or permanent residents, are prohibited immigrants – a person certified by a Health Officer to be suffering from a communicable disease that makes his entry into the Islands dangerous to the community.”
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the Cayman Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
As in Great Britain and its other colonies, vehicles in the Cayman Islands travel on the left-hand side of the road (the opposite side compared with driving in the United States). Due to their size, the Caymans have little highway infrastructure to maintain. Local driving standards, the risk of accidents, the availability of emergency roadside service, quality and frequency of signage, and enforcement of traffic laws, generally meet the standards of the United States. Visitors must obtain a temporary driver's license, easily granted upon presentation of a valid state driver's license and payment of a small fee, at a car rental agency or a police station. Laws against driving while intoxicated are strictly enforced, with a legal maximum blood alcohol level set at 100 milligrams per 100 milliliters of blood. Seatbelt laws are also enforced and require the driver and all passengers to wear seatbelts while in motion. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.caymanislands.ky
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Cayman Islands’ Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Cayman Islands’ 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:
Cayman Islands customs authorities may enforce strict regulations concerning temporary importation into or export from the Cayman Islands of items such as firearms of any kind, spear guns (or pole spears or Hawaiian slings), live plants and plant cuttings. Raw fruits and vegetables are also restricted. Visitors from the United States should be aware that products made from farmed green sea turtles at the Cayman Turtle Farm Ltd. are offered for local consumption; however, the importation of genuine sea turtle products is strictly prohibited by the United States, as well as other countries that have signed the Convention on International Trade in Endangered Species. In addition, U.S. Customs prohibits the transshipment of turtle products through the United States and any products discovered will be confiscated. It is advisable to contact the Collector of Customs (345) 949-2473 for specific information regarding customs requirements. Please see our Customs Information.

The Cayman Islands, like all Caribbean countries, can be affected by hurricanes. Hurricane season runs from June 1 to November 30 each year. The Office of Disaster Preparedness and Emergency Management (ODPEM) has put measures in place in the event of an emergency or disaster. General information is available on the subject via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating the Cayman Islands’ laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Cayman Islands are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the Cayman Islands are encouraged to register with the U.S. Embassy in Kingston, Jamaica through the State Department's travel registration web site, and to obtain updated information on travel and security within the Cayman Islands. Americans without Internet access may register directly with the U.S. Consular Agency in George Town, Grand Cayman or the U.S. Embassy in Kingston, Jamaica. By registering, American citizens make it easier for the Embassy or Consular Agency to contact them in case of emergency. The U.S. Consular Agency in the Cayman Islands is located at 222 Mirco Center, North Sound Road, Georgetown, Grand Cayman. Its phone number is (345) 945-8173. Office hours are Monday, Wednesday, and Friday from 08:00 a.m. to 2:00 p.m.

American citizens requiring assistance in Cayman may also contact the American Citizen Services Unit of the U.S. Embassy in Kingston, Jamaica at (876) 702-6000. The Consular Section of the U.S. Embassy is located at 142 Old Hope Road,, Kingston 6. Office hours are Monday through Friday (except Jamaican and U.S. holidays), 7:15 a.m. to 4:00 p.m., with window services 8:30 to 11:30 a.m. Both the Consular Agency and Embassy may provide updated information on travel and security within the Cayman Islands. The Embassy web site is http://kingston.usembassy.gov/
* * *
This replaces the Country Specific Information for the Cayman Islands dated December 3, 2007, to update sections on entry/exit requirements, crime, and medical facilities.

Travel News Headlines WORLD NEWS

Date: Mon 19 Feb 2018
Source: Cayman Compass [edited]

An outbreak of hand-foot-mouth disease that surfaced a few weeks ago is still affecting some schools on Grand Cayman.

The disease is not uncommon on the island and typically affects children under 10 and especially those aged 5 and younger. Children with the virus typically have a fever, sore throat, a red rash on the palms of the hands and soles of the feet, mouth sores, and loss of appetite. There is no specific treatment other than to let the illness run its course. The best prevention is practicing good sanitation and hygiene.

Tim McLaughlin, an epidemiologist with the Public Health department, said the 14 cases reported from 4-10 Feb 2018 were the most he has seen in a single week. Figures for last week [week of 12 Feb 2018] are not yet available, but Mr McLaughlin said it looked as though the spread of the disease had slowed down. Most children were out of school last week and that may be a factor, he said

"14 in a week is a lot," Mr. McLaughlin said. "It also tells me there are more cases out there."

As a consequence, he said, he is more closely monitoring the spread of the disease, which is not uncommon this time of year. If need be, he said, "We'll sound the alarm."

At the Department of Education Services, director Lyneth Monteith said she was unaware of any public schools currently being affected by the disease. But preschools are seeing the problem.

Bri Bergstrom, the owner of the Montessori School of Cayman, said 3 of her students came down with the illness 3.5 weeks ago. It was the 1st such outbreak at the school, she said, adding that no other students have since been affected.

"It seems to be going around," Ms Bergstrom said. "It's almost impossible to avoid sometimes, things coming into the school."

She and others operating schools and preschools said that they have increased their efforts to keep classrooms and play areas sanitary by cleaning more often and doing thorough deep cleaning.

"Even when the flu is going around, we always amp up the sanitation," Ms Bergstrom said.

At the Treasure Garden, a preschool with 35 students, teacher Tonie-Ann Broomfield said 6 pupils have contracted the disease over the past 2-3 weeks. Some of the students, she said, showed no outward symptoms, such as a fever, before breaking out in a rash. She said the staff is being more vigilant.

"As soon as we check their temperature and it's above 100 deg F [37.8 deg F], we call the parents and ask them to take them to the doctor," Ms Broomfield said, adding that the child is kept isolated from other children until they are picked up.  [Byline: Mark Muckenfuss]
========================
[Hand-foot-mouth disease is caused by viruses that belong to the _Enterovirus_ genus (group), which includes polioviruses, coxsackieviruses, echoviruses, and other enteroviruses. - Coxsackievirus A16 is typically the most common cause of hand-foot-mouth disease in the United States, but other coxsackieviruses can also cause the illness. - Enterovirus 71 has also been associated with cases and outbreaks (<https://www.cdc.gov/hand-foot-mouth/outbreaks.html>) of hand-foot-mouth disease, mostly in children in East and Southeast Asia. Less often, enterovirus 71 has been associated with severe disease, such as encephalitis.  - Several types of enteroviruses may be identified in outbreaks of hand-foot-mouth disease, but most of the time, only 1 or 2 enteroviruses are identified.

Generally, a person with hand-foot-mouth disease is most contagious during the 1st week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Some people, especially adults, may become infected and not develop any symptoms, but they can still spread the virus to others. This is why people should always try to maintain good hygiene, such as frequent handwashing, so they can minimize their chance of spreading or getting infections. (Excerpted and edited from <https://www.cdc.gov/hand-foot-mouth/about/transmission.html>). - ProMED Mod.LK]

[HealthMap/ProMED-mail map
Grand Cayman, Cayman Islands: <http://healthmap.org/promed/p/7955>]
Date: Fri 2 Feb 2018
Source: Cayman News Service [edited]

The [Cayman Islands] Public Health Department is issuing an alert for travellers after at least 2 cases of measles were confirmed in the Caribbean and Central America that appear to have been imported from Europe. There have been no cases of measles in the Cayman Islands since 1990. Local immunisation coverage against the disease is around 90% among 15-month-old children and about 97% by the time they reach school age. But officials are urging anyone who becomes unwell after returning from the UK and Europe as well as parts of the US to visit a doctor.

People who are experiencing a sudden high fever accompanied by a rash should seek medical attention immediately and provide their travel history to the doctor for necessary investigation.

"If you are travelling to any of the affected areas where measles has been confirmed, safeguard yourself and your family by ensuring that your and your children's immunisations against measles are up to date," advised Nurse Angela Graham, manager of the Health Services Authority's Expanded Programme on Immunisation. "Unprotected children are at the greatest risk of contracting this virus, should a case be imported to the Cayman Islands. It is the responsibility of parents and guardians, alike, to ensure that their children are protected."

Dr Samuel Williams-Rodriguez, Acting Medical Officer of Health, said that while there has been great progress in the fight against measles regionally, there is a risk of spread and sustained transmission in areas with susceptible populations.

"Vaccination with at least 2 doses remains the most effective measure," he said. "I emphasise that measles can be reintroduced as we have many residents and visitors travelling to and from the Americas and European countries. We should therefore remain vigilant."

He added, "The 1st sign of measles is usually a high fever which begins about 10-12 days after exposure to the virus. A runny nose, cough, along with red and watery eyes and small white spots inside the cheeks, can develop in the initial stage followed by a rash on the face and upper neck, eventually reaching the hands and feet."

Measles is caused by a virus which grows in the cells that line the back of the throat and lungs. It is a human disease and is not known to occur in animals. Close contact with other people following the onset of rash must be avoided 7 for days.

For complete protection, children older than 12 months should have 2 doses of MMR (measles mumps and rubella) vaccine. Children between 6 and 11-months, who are travelling abroad, are recommended to have one dose of MMR vaccine.
====================
[Maps of the Caribbean and Central America can be found at
Date: Thu 17 Apr 2014
Source: cayCompass.com [edited]

More than 400 feral chickens in Bodden Town have died of botulism, according to a post-mortem examination carried out by the Department of Agriculture. The birds began dying more than 2 weeks ago, residents in the area said. Brian Crichlow of the Department of Agriculture said a post-mortem exam on one of the birds revealed botulism. The bird was also tested for avian flu, with negative results. Mr Crichlow said botulism is not spread by direct contact with affected chickens, but there is a "low potential for spreading to humans and other animals through consumption of dead chickens" contaminated with the botulism toxin.

Botulism is a micro-organism that occurs naturally in the soil and in decaying flesh. Since chickens are scavengers, they likely ate a dead animal and got sick, said Mr. Crichlow.

The Department of Environmental Health was expected to begin removing the birds from the site, near the Bodden Town Mission House, on Wednesday afternoon [16 Apr 2014], according to the department's director, Roydell Carter. "We are aware of the situation. We were notified by the Department of Agriculture about it. We went on site today [Wed 16 Apr 2014] and we will be assisting them in getting the birds removed and disinfecting the area," he said. "We're putting together the resources we need -- there are so many [dead chickens] all over the place ... We will go in and help. There could probably be public health implications as well [if the carcasses are not removed]. We don't want all these dead birds lying around ... where other animals might feed on their carcasses," he added.

On Wednesday [16 Apr 2014], many of the dead chickens could be seen around the Mission House and Harry McCoy Park, and under the home of an elderly couple nearby. Mr Crichlow advised that if the dead or dying birds are not removed and disposed of properly, other chickens will feed on the carcasses and the maggots from the dead chickens, leading to more chickens contracting botulism. Botulism is also known as "limberneck," he said, reflecting the neck paralysis typically seen in affected birds. [The son] of the couple under whose home many of the decaying carcasses were seen, said he had picked up as many as he could, but those under the house would have to stay there until he had help removing them.

"The chickens just get crippled, lie down and die," said [the man], who often fed the chickens. For the past 2 weeks, the chickens have been "dropping off like flies," he said.

The feral chickens roam the neighborhood and are considered pests by many in the area. Mr Crichlow said there had been no reports of domestic flocks of chickens owned by local farmers being affected by botulism. However, he said the department had seen similar episodes before of local wild chickens dying, adding that botulism is common in feral chickens in Cayman and elsewhere. Over the past 2 years, his department has responded to deaths of feral chickens in George Town, West Bay and Bodden Town districts, he said.

Karen Rosenthal, a St. Matthews Veterinary School veterinarian who studies birds, said, "It is not so easy for people to get botulism the same way chickens do. But you would never eat the eggs or meat from a chicken with botulism," she said. "What we should worry about is if the people are using the same water source as the dead birds."

Kiran Kumar, medical officer of health at the public health department, said botulism from dead chickens does not spread to human beings through the air, and there is also no evidence of it spreading to humans by consumption of chickens with botulism. However, he advised against eating infected chickens to "prevent any rarest possibility of such occurrence."   [Byline: Jewel Levy]
========================
[Avian botulism is much more often seen in wild ducks and other water birds. But we do have a prior report of an Australian incident which is very similar to this Cayman report. The Australians ascribed it to a buildup of the causative organism, _Clostridium botulinum_, in the soil. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/38613>.]
Date: Fri 17 Jan 2014
Source: Businessweek [summ., edited]

The 1st known outbreak of the chikungunya virus in the western hemisphere has Caribbean governments working to prevent the disease from spreading and damaging the region's tourism-dependent economies.

About 280 cases of chikungunya [virus infection; many more cases than this, see other reports - ProMed Mod.TY], which can cause severe joint pain, fever and headaches, have been reported since early December [2013] in Dutch and French Saint Martin, Saint Barthelemy, Martinique, Guadeloupe, Dominica, the British Virgin Islands, and French Guiana. Officials from Venezuela to the Cayman Islands have warned of the potential for the mosquitoborne virus, 1st identified from a patient in Tanzania in 1953, to spread. There is no treatment, and the illness is rarely fatal.

"The worst case scenario would be that the impact would be significant and slow down the whole economy in the Caribbean," James Hospedales, the executive director of the Caribbean Public Health Agency, said by telephone. "The Caribbean is the most tourism-dependent region in the world, so if it spreads like wildfire you could scare away tourists."   [byline: Isabella Cota and Elizabeth Lopatto]
=====================
[This report is a good illustration of potential adverse economic effects when a new disease appears in a major tourist destination. Although dengue fever poses greater health risks, the addition of a 2nd virus disease to the area increases concern on the part of the traveling public. - ProMed Mod. TY]
Date: Mon 17 Sep 2012.
Source: Cay Compass [edited]

The Cayman Islands Mosquito Research and Control Unit and Oxitec have cited an 80 per cent reduction in the numbers of _Aedes aegypti_ mosquitoes in Grand Cayman after introducing genetically modified mosquitoes into the environment as a control measure. This finding, which was officially published in a report in Nature Biotechnology, was previously reported in the 17 Jan 2012 edition of the Caymanian Compass.

One of the main reasons the report said led to the Cayman Islands "having a need the need for alternative measures of control" was the high level of resistance to insecticide shown by _Aedes aegypti_ mosquitoes in Grand Cayman. The report references research done by MRCU Entomologist Angela Harris and Hilary Ranson of the Liverpool School of Tropical Medicine, who in their findings, "Pyrethroid Resistance in Aedes Aegypti," stated: "The Grand Cayman population of _Aedes aegypti_ is highly resistant to DDT and pyrethroid insecticides."

In an interview with the Caymanian Compass, Dr. Harris said, "For our experiments regarding the issue of resistance to insecticides we used mosquitoes that have been in a secure environment for over 30 years in a colony that was bred repeatedly over time and then compared those with the mosquitoes from the Grand Cayman. The results indicated that those found here are much more resistant and could be exposed to DDT for up to 8 hours."

Ms Harris added that the _Aedes aegypti_ mosquito has only been in the Cayman Islands since 2002 and could have likely acquired its resistance from its places of origin, which have not been determined. She also surmised that their resistance level could be as a result of cross-resistance from a pyrethroid resistance. In any event, much of Dr. Harris' research going forward will be to substantiate the theory that the mosquitoes came to the Cayman Islands with the resistance as opposed to developing it here. The Cayman Islands has never used DDT in its mosquito control efforts.

However, the Mosquito Research and Control Unit of the Cayman Islands was scrutinised in the foreign press for using genetically modified _Aedes aegypti_ mosquitoes to combat the spread of dengue fever. It was the 1st time the method was being used in a real world test area.

At the time, Bill Petrie, director of MRCU, said the initiative was essentially a new spin on an old technique in which males that were made sterile were released. He added that the difference here is that the male mosquitoes' genes were altered, as opposed to their sterility being chemically induced by radiation.

"MRCU along with Oxitec of Oxford University ran the trial for 6 months," Mr. Petrie said. "We chose a small isolated area in East End. This was done in 3 blocks; one block was where the method was introduced, while nothing was done in another block and the 3rd block was used to monitor the natural population of the _Aedes aegypti_ mosquito.

"Once the team perfected the technique, monitoring was done by traps. The final statistical analysis has shown a significant reduction in the population of this potential dengue carrier," he added.

Mr. Petrie said the male _Aedes aegypti_ mosquito cannot bite and lives a short life-span and since their eggs will not survive using this new method of control, the population of the species has decreased, as did the probability of dengue fever transmission.  Since the Cayman Islands' success using the genetic modification technique, several other jurisdictions are following suit.

"Dengue is a dangerous and debilitating disease, which affects up to 100 million people each year. The incidence of dengue has grown very rapidly in recent years: it is now a serious threat to global health, and the only means of prevention is to target the mosquitoes which carry it. We need new tools in the fight against these dangerous pests, and today's publication shows that Oxitec's approach can provide that," Mr. Petrie said.   [Byline: Stuart Wilson]
======================
Reference:
Harris AF, Nimmo D., McKemey AR, Kelly N, Scaife S, Donnelly CA, Beech C, Petrie WD, Alphey L. Field performance of engineered male mosquitoes. Nat Biotechnol 2011 Oct 30;29(11):1034-7.

[This is an interesting field experiment that produced an 80 per cent reduction in the _Aedes aegypti_ population through release of genetically modified mosquitoes into a population of native mosquitoes resistant to 2 common pesticides. The release of genetically modified mosquitoes will be considered controversial and opposed by some, but alternatives such as increasing use of pesticidal chemicals have been of limited success in medium- to long-term vector population reduction efforts. It will be interesting to see how successful the release of these genetically modified mosquitoes will be in other locations. An effective, commercially available dengue virus vaccine is still several years away. Meanwhile, vector control is the only way to prevent dengue virus transmission. - ProMed Mod.TY]

[A HealthMap/ProMED-mail map showing the location of the Cayman Islands in the Caribbean can be accessed at: http://healthmap.org/r/1IG3.]
More ...

Finland

Finland - US Consular Information Sheet
January 13, 2009
COUNTRY DESCRIPTION:
Finland is a highly developed democracy with a modern economy.
It is a member of the European Union.
Tourist facilities are widely available.
Read
the Department of State Background Notes on Finland for additional information.
ENTRY REQUIREMENTS:
Finland is a party to the Schengen agreement.
As such, U.S. citizens may enter Finland 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 Schengen fact sheet.

Travelers can contact the Embassy of Finland at 3301 Massachusetts Avenue, N.W., Washington, DC 20008, tel: (202) 298-5800, or the Finnish Consulates General in Los Angeles or New York.
Additional information is available via the Internet at http://www.finland.org.
The U.S. Embassy in Helsinki is not able to assist private U.S. citizens in obtaining any necessary visas for neighboring countries, including Russia and other countries of the former Soviet Union.

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:
Finland remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Finland’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
Elements of organized crime groups operating in the former Soviet Union and Eastern Europe are present in Finland, but these do not represent a specific danger to U.S. citizen residents or tourists.
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 United States and Canada, or for callers outside the United States and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Although the crime rate in Finland is low compared to the U.S. and most European countries, it has increased in recent years; however, Finland remains a relatively safe environment.
Americans visiting Finland are seldom victims of crime, but visitors should not be complacent regarding personal safety or the protection of valuables.
The same precautions employed in the U.S. should be followed in Finland.
Finnish police services are excellent. Travelers should be aware that some police officers speak little English.
Due to the low crime rate, Finland has one of the lowest numbers of police officers of any European nation.
Outside of key sites in major urban centers, they rarely project a visible presence; consequently, response times to crisis situations may be unpredictable.
All forms of public transportation are considered safe.
Street crimes, such as muggings and pick-pocketing, remain uncommon, but do occur.

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.

Finland has a program to provide financial compensation to victims who suffer serious criminal injuries.
According to existing regulations, the victim must report the incident to the police and file an application for compensation within 10 years of the date of the crime.
Finnish police routinely inform victims of serious crime of their right to seek compensation.
The relevant forms and further information can be obtained from http://www.treasuryfinland.fi.
The local equivalent to the “911” emergency line in Finland is 112.
Please see our additional information for Victims of Crime, including possible victim compensation programs in the United States.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country’s laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Finland’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Finland 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
SPECIAL CIRCUMSTANCES:
Commercial and financial transactions in Finland are increasingly automated and on-line.
Cash is almost always acceptable (the currency is the euro), but most major credit cards are widely recognized.
Automatic Teller Machines are very common and many U.S.-issued bankcards are compatible with them.

MEDICAL FACILITIES and Health information:
In Finland, medical facilities and their staff are generally excellent and are widely available for emergency services.
English is commonly spoken by Finnish medical personnel.
Helsinki is a frequent medical evacuation point for emergency cases from the countries of the former Soviet Union.
The public hospital system and many private hospitals honor foreign credit cards.
Most pharmacies (“apteekki” in Finnish) are open during normal shopping hours and major cities have at least one 24-hour service pharmacy.
If you are a tourist or temporary visitor to Finland and you require immediate emergency medical assistance, you may visit a local medical center or clinic, called “ensiapuasema” (first-aid station) in Finnish.
Usually these stations are located at hospitals and provide a full range of services.
The emergency telephone number, 112, can be used throughout Finland to contact emergency medical services.
For more detailed information on medicines and medical issues, please visit the website of the Finnish Embassy in Washington, DC at http://www.finland.org.
Travelers with special medical needs should consult with their personal physicians and take appropriate precautions, including bringing adequate supplies of necessary medication.
Medicines may be brought into the country as long as they are intended for the traveler’s personal use, however, there are special requirements concerning the quantity.
Medications categorized as narcotics may only be brought into the country to cover the traveler’s personal use for a maximum of 14 days and must be accompanied by a medical certificate stating why the traveler needs them.
For more detailed information, please contact the Finnish Embassy in Washington, DC at http://www.finland.org
In addition, stringent Finnish customs regulations prohibit travelers from receiving drugs from abroad after having arrived in the country.
Travelers may also find local physicians reluctant to prescribe equivalent quantities of dosages.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Finland.
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.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Finland is provided for general reference only and may not be totally accurate in a particular location or circumstance.
Finnish roads are comparable to those in the U.S., though secondary roads may be less heavily traveled due to Finland’s sparse population outside the major urban areas.
These secondary routes often narrow to two lanes with a wider shoulder.
Slower vehicles are expected to move onto the shoulder to allow faster moving vehicles to pass.
Finland has an extensive network of highways throughout the country, as well as excellent public transportation services.
A valid U.S. driver’s license may be used while visiting Finland, but drivers must be at least 18 years of age.
Driving in Finland is on the right.
Traffic approaching from the right usually has priority, even if entering a primary roadway from a secondary one.
Road signs use standard international symbols and Finnish text.
Many urban streets have traffic lanes reserved for public transportation only.
Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 120 km/h on expressways during summer (reduced to 100 km/h during winter).
Vehicles must use headlights at all times.
Use of seatbelts is mandatory for drivers and all passengers.
Minor children must be seated in approved child or booster seats.

Public transport in Finland is of good quality and is the recommended method of travel.
Passenger trains, intercity buses, and air flights provide regular service over longer distances.
Public transportation in urban centers includes buses, subways, trams, suburban trains, and taxis.
Taxis are more expensive than in major U.S. cities.
Most local residents use public transport in Helsinki as parking can be hard to find and expensive.
The bus, train, and subway systems are relatively safe.
Travelers should be aware that drunk-driving laws are strict and acceptable blood alcohol levels are much lower in Finland than in the U.S.
Police strictly enforce all traffic laws and institute random roadside breath analyzer tests.
Drivers who register .05 or above alcohol content are subject to immediate arrest.
Drivers should be aware that regulations and traffic signs differ significantly from those in the U.S.
Visitors should be familiar with both prior to operating a vehicle in Finland.
Driving in Finland during the winter months can be hazardous.
Daylight hours are very short and one should be comfortable with driving in darkness.
Icy road conditions are common.
If driving in Finland, the vehicle must be winterized with studded snow tires and engine heaters are strongly recommended.
When driving at night, drivers must be alert to moose wandering onto major roadways.
There have been incidents of moose being struck by vehicles, causing severe damage to the vehicle and injury, sometimes fatal, to the occupants.
For real-time updates on road conditions throughout Finland, see the Finnish Road Administration’s travel and traffic information web site at http://www.finnra.fi
Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.mek.fi
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Finland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Finland’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
Please see our information on customs regulations.

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

REGISTRATION AND EMBASSY LOCATION:
Americans living or traveling in Finland are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website, https://travelregistration.state.gov, so that they can obtain updated information on travel and security within Finland.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Itainen Puistotie 14B.
The telephone number for the American Citizens Services unit is 358-9-616-25-701, 0830 to 1700 Monday to Friday (after hours, 358-9-616-25-0); the fax number is 358-9-616-25-800; e-mail:
HelsinkiACS@state.gov.
The address of the Embassy’s Internet home page is http://www.usembassy.fi
*

*

*
This replaces the Consular Information Sheet dated May 23, 2008 to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Fri 14 Dec 2018
Source: UUTISET [edited]

An unvaccinated individual, who caught the contagious disease in Poland, attended a large church service in Tampere and infected at least 2 other people. Three adults have been diagnosed with measles in Tampere after attending a Catholic parish church event in late November along with more than 100 people, according to the Pirkanmaa Hospital District.

Two of the adults diagnosed have been vaccinated, so they are not contagious. The source of the outbreak is an unvaccinated person, who caught the measles in Poland. But according to the Pirkanmaa Hospital District, further cases may still arise.

In 1975 Finland began to administer a single dose of the measles vaccine to all one-year-olds and by 1982 Finland began administering the vaccine in 2 doses between the ages of 1 and 6. However some people born in the 1970s are among those who received only one jab. MMR is a triple-dose vaccine that provides protection against measles, mumps and rubella.

Measles spread at religious event
---------------------------------
The event in question was Tampere's Pyhan Ristin (Sacred Cross) Catholic Parish church mass on 25 Nov 2018. It was attended by more than 100 people, including children. Pirkanmaa Hospital District doctor Kirsi Valve, a specialist in infectious diseases, confirmed that the infected individual who caught the measles in Poland was at the church event. The cases came to light when 2 vaccinated individuals contracted high fevers and came down with skin rashes. The unvaccinated person, who infected the others, has had more severe symptoms than the vaccinated individuals.

"The individuals quickly got in touch with healthcare services owing to high fevers, and skin rashes that rapidly spread all over their bodies," says Valve. "It was confirmed that on 25 Nov 2018 the unvaccinated individual who caught the measles in Poland and brought it back to Finland was at the parish event and is the source of the outbreak."

As the source of the outbreak is known, healthcare officials are also looking into whether the person could have possibly exposed others.

Measles in the news
-------------------
Measles has been on the agenda this winter after an unvaccinated child in Ostrobothnia took ill with measles. Meanwhile, it also came to light that many adults in Finland may not have been vaccinated against measles during the early 1970s.

Measles is a rare disease. The previous outbreak was 2 summers ago when 4 vaccinated children caught measles in Italy and started showing symptoms after returning to Finland. The Pirkanmaa Hospital District recommends that anyone who attended the Catholic parish event in late November 2018 and exhibits symptoms that suggest measles or anyone who hasn't been vaccinated with the MMR vaccine contact their healthcare centre.

If those who attended the parish event are healthy, but have not been vaccinated, the Pirkanmaa Hospital District recommends that they contact their healthcare centre to be vaccinated. The measles vaccine is free and administered as part of the MMR shot, which also provides protection against rubella and the mumps.
Date: Fri 2 Nov 2018
Source: UUTISET [edited]

Around 1/3 of the ticks in Finland -- mostly found in the south -- carry at least one pathogen, and 2 percent of the persistent arachnids carry several disease-causing agents, researchers at Turku University said.

About 30 percent of common ticks and 24 percent of taiga tick populations have been found to carry one disease pathogen. Common ticks more commonly carry several disease-causing pathogens than taiga ticks, according to the researchers.

The most common pathogen found in the ticks was _Borrelia burgdorferi_, the bacterial species that causes Lyme disease in humans, an illness referred to locally as borreliosis. The pathogen was found in 17 percent of the ticks at the university's growing tick database bank.

Lyme disease cases are treated with aggressive antibiotics without necessarily determining which specific bacterium is responsible for the infection.

Thanks to a growing tick database at the University of Turku, researchers have new insights into the disease pathogens that the tiny, blood-sucking arachnids carry.

New research has revealed that ticks on the south coast carry the most pathogens, but the region is almost exclusively home to the most common ticks: _Ixodes ricinus_, or castor bean ticks).

Both castor bean ticks and taiga ticks [_Ixodes persulcatus_] are now commonly found in areas across central Finland, the researchers said. Even further north, the tick populations are quite similar to ones in central areas, but the taiga has become more common in the north.

About 3 years ago, researchers at the university asked members of the public to send in ticks they had found, and now the institution has received more than 20 000 ticks. The researchers say that they want to take advantage of the significant amount of information they can learn from the specimens.

Examination of those thousands of tiny arachnids have uncovered many types of disease-causing bacteria, and researchers have new insights into the arachnids themselves and the potential illnesses they carry.

The researchers said they hope to learn more about ticks, saying that their research has only begun, and that their study of the ticks will continue for several years. Ultimately, their goal is to find how tick-borne illnesses are transmitted, they said.
======================
[This is an interesting example of how a large group of people, many undoubtedly non-scientists, can contribute to an effort that requires many hours of collection effort. Although _Borrelia burgdorferi_ is endemic in Finland, finding it and possibly other bacterial pathogens in about 1/3 of the 20 000 ticks collected is of public health significance. _Ixodes ricinus_ is also the tick vector of European tick-borne encephalitis virus, but no mention is made of it in the above report. Perhaps it was not tested for. Images of both ticks can be found in the above report. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu, 1 Nov 2018 16:46:12 +0100
From: topic@afp.com

Helsinki, Nov 1, 2018 (AFP) - Santa Claus has already begun his preparations in Lapland -- by protecting himself from winter viruses and making sure he hires enough elves.   On Thursday nurse Tiia Kahkonen administered an anti-influenza vaccine to Santa, at his village in the Arctic Circle town of Rovaniemi, northern Finland. 

The jab is likely to be a sensible precaution, as the flu season coincides with the busiest time of the year by far in Lapland.    In December last year 390,000 foreign visitors spent a night in Finnish Lapland, an increase of almost ten percent on the previous Christmas.    By far the largest group of Christmas holidaymakers were Brits, followed by Russian, French and German tourists, according to official statistics.

Meanwhile a recruitment agency in Finnish Lapland, inside the Arctic circle, has put out a call for Christmas elves to look after the hordes of tourists who come to visit Santa in his natural habitat during the winter months.   Prior experience is not essential as the advert, posted by the firm Lapland Staff, promises that training will be provided in "the required elfing and communication skills."   Successful applicants will also be given tips on how to deal with the cold in northern Finland where temeratures rarely rise above zero degrees Celsius, and can drop as low as minus 40.

Although handling Santa's reindeer is not listed among the job's duties, elves will need to herd groups of visitors on and off buses, as well as keep tourists entertained. "Looking after the fireplace and pouring hot juice" are also required, as is supervising the toboggan hill.   Tourism to Lapland has reached an all-time high in recent years, with visitors spending 3.5 million nights in Lapland across the whole year, up from 2.6 million a decade earlier, according to Statistics Finland.    Much of the recent growth has been driven by tourism from Asia.
Date: Sun, 17 Dec 2017 04:43:36 +0100
By Camille BAS-WOHLERT

Rovaniemi, Finland, Dec 17, 2017 (AFP) - In the run up to Christmas tourists from around the world flock to the Santa Claus Village, an amusement park in Finnish Lapland, where temperatures can hit nearly -15 degrees Celsius (5 Fahrenheit).    They buy soft toys and souvenirs from pricey gift shops while a bearded Santa receives hundreds of admirers a day throughout December before embarking on his world tour from the valleys of Finland to the skyscrapers of New York and beyond to deliver gifts.

Holding their winter beanie hats in their hands, visitors wait patiently in line for a brief encounter with "Joulupukki" -- the Finnish word for Santa Claus -- and a photo opportunity in exchange for hard currency.    "We've seen other Santas but that wasn't the real one. But we're told that is the real one," said Mary Gleadall, an eight-year-old tourist from Southampton in the UK, visiting the amusement park with her parents, brother and sister.    According to Christmas lore, Santa lives in a secret place in the middle of the snowy pines of the North Pole. But the question is where?     Since 2010, Rovaniemi, the capital of Finnish Lapland, has marketed itself as Santa's "official home".    Situated a few miles from the city, the Santa Claus Village is located in front of a huge gas station. 

Tourists rush to cross the Arctic Circle, marked by a white line, to meet Santa Claus in his wooden home with a pointed roof.    But entering his private cottage is out of the question as Mother Claus is reportedly protective of their privacy.    In a large room, the white-bearded old man sits in an armchair next to a chest full of letters.    Each year, he receives more than 300,000 visitors, a deluge he embraces with humility.    "I'm very happy. I'm not exhausted but, of course, I get tired once in a while" he says.    And how does Santa Claus regain his energy?    "I love to take nap every once and then. Fifteen minutes sleeping and then all is very good." he says.

- Exalted tourists -
Shizuka Kawahara and Saki Itoi, Japanese tourists in their thirties, flew for more than 24 hours to hug Santa for a few seconds in a precious moment immortalised with a photograph taken by an elf.    The price for one shot starts at 30 euros ($35). Photographing with one's own camera is forbidden as it would ruin the magic of the moment, says the staff of the house.     Four-year-old Harry Gleadall, Mary's brother, approaches Santa without fear.    He quickly states his list of what he wants for Christmas: Transformers and some more Transformers before he skeptically shakes Santa's hand.    "But what if it wasn't the real Santa Claus?" Harry asks with concern.    Eager to set the record straight -- and justify the long trip -- his mother quickly assures him that the chubby red-clothed man is indeed the real deal.    After a tour around the shop which sells hand-made "Lapland" emblems and tons of souvenirs, the family is back in the village square, surrounded by wooden homes, Christmas carols piped out of nearby speakers.

- Polar safari -
In this winter wonderland, tourists have the opportunity to go on a reindeer sleigh ride.    A snow "safari" of 400 metres costs 14 euros per child and 18 euros per adult, an exotic experience for many foreigners who seek to discover the arctic landscapes steeped in pink light.    The -13 degrees Celsius does not discourage the plucky visitors bundled up in their ski suits.    "Everything that have been told to me during childhood, it's come true," said Perpetua, a tourist from Dubai, describing the break from the year round desert climate as "heaven".   "We expected magic and this is what we found," added Max, an Italian tourist. "Everything seems to be magic, the lights, the place, everything here".   But Miriana, a 24-year-old Italian on a university exchange programme in southern Finland, was less convinced.   "The place is really nice. But I think nevertheless that it's a bit commercial," she said.
Date: Tue 18 Oct 2016
From: Tiina Nokireki <tiina.nokireki@evira.fi> [edited]

The Finnish Food Safety Authority (Evira) received a bat (Daubenton's bat, _Myotis daubentonii_) for laboratory analyses. The bat was found by a private person. The bat had neurological signs and then died.

Laboratory analyses conducted during the 13 and 14 Oct 2016, confirmed the presence of rabies by FAT. The virus was then identified as European Bat Lyssavirus type 2 (EBLV-2) by RT-PCR and partial sequencing of the gene for the nucleoprotein. Also cell culture is positive.

The bat originated from Inkoo in the province of Southern Finland and is part of the Uusimaa region. This is the 2nd case of EBLV-2 in a bat in Finland.
-----------------------------------------
Tiina Nokireki
Head of Section, DVM, Specialist in Veterinary Medicine, Infectious
Diseases
Finnish Food Safety Authority Evira
Research Department, Veterinary Virology
Mustialankatu 3,
FI-00790 Helsinki,
Finland
=========================
[Special thanks to Dr. Nokireki for this important contribution. Infections by European Bat Lyssavirus type 2 (EBLV-2) have been previously reported in Northern Europe, not only in bats, but also in humans. EBLV-1 appears to be more prevalent, accounting for the vast majority of all EBLV-infected bats. Reports of EBLV-2 correspond to Daubenton's bats (_Myotis daubentonii_), indicating that this bat species is the reservoir of this _Lyssavirus_ strain.

For a picture of a Daubenton's bat go to

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

Palau US Consular Information Sheet
March 10, 2009
COUNTRY DESCRIPTION:
The Republic of Palau is a constitutional democracy in free association with the United States.
Palau is an archipelago consisting of several hundred volcanic and
limestone islands and coral atolls, few of which are inhabited, and is politically divided into 16 states.
Palau’s developing economy depends on tourism, marine resources and a small agricultural sector.
Two kinds of public transportation are available, taxi and Airai bus service.
Palau International Airport is located on Babeldaob Island, near Koror Island.
Direct commercial air service to Palau exists from Manila, Taipei, and Guam.
Read the Department of State Background Notes on Palau for additional information.

ENTRY REQUIREMENTS:
Citizens and nationals of the United States of America, with the exception of United States military personnel, must have a passport valid for at least six months from date of entry.
A visa is not required for U.S. citizens visiting Palau for one year or less, provided the visitor otherwise complies with applicable regulations, for example, on employment.
U.S. military personnel must present official orders or documents certifying status; U.S. military dependents ten years or older must have a U.S. Government-issued photo-identification card showing the name, date of birth, and status of the bearer. For more information about entry requirements to Palau, travelers may consult with the Embassy of Palau, 1700 Pennsylvania Avenue NW, Suite 400, Washington, DC 20036, (202) 452-6814.
Visit the Embassy of Palau’s web site for the most current information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information Sheet.
SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME:
Although the crime rate in Palau is relatively low, foreign residents can be the target of petty and, rarely, violent crimes, as well as other random acts against individuals and property.
Therefore, visitors should not be complacent regarding personal safety or the protection of valuables.
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.

The local equivalent to the “911” emergency line in Palau is: 911.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than those in the United States for similar offenses.
Persons violating Palauan laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Palau are severe, and convicted offenders can expect jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
SPECIAL CIRCUMSTANCES:
The official currency of Palau is the U.S. dollar.
Major credit cards, including Visa, Mastercard, and American Express, are accepted in most locations catering to tourists. There are several ATMs in Koror, located at branches of U.S. banks.

Koror State, where most tourist facilities are located, enforces a curfew between 2:30 a.m. and 5:00 a.m. Monday through Thursday, and between 4:00 a.m. and 6:00 a.m. Friday to Sunday and on national holidays.
Firearms of any kind are strictly prohibited in Palau.
The penalty for possession of a firearm or ammunition is up to fifteen years imprisonment.
Palau customs authorities may enforce strict regulations concerning temporary importation into or export from Palau of certain other items.
It is advisable to contact the Embassy of Palau in Washington, D.C., for specific information regarding customs requirements.
General information regarding disaster preparedness is available via the Bureau of Consular Affairs' website, and from the U.S. Federal Emergency Management Agency (FEMA) home page.

Please see our Customs Information sheet.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Health facilities in Palau are adequate for routine medical care, but limited in availability and quality.
Doctors and hospitals often expect immediate cash payment for health services.
Serious medical conditions requiring hospitalization or evacuation to the United States or elsewhere may cost thousands of dollars.

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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Palau is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Palau accepts a driver's license issued by a U.S. state or military authority.
Many roads in Koror, where the vast majority of the population lives, are in fair condition, but lack sidewalks and have little or no shoulder.
Construction of the main road connecting the airport with downtown Koror has been completed.
In addition, the newly constructed roadway, known as the “Compact Road,” that loops around the large island of Babeldaob is in excellent condition.
Secondary roads connecting villages to the Compact Road vary in quality from good to rough.
The national speed limit is 25 miles per hour, but drivers routinely ignore this limit on the good-quality roads, and traffic often moves slower in congested areas.
Passing slow-moving vehicles is illegal, but drivers do this routinely, creating potentially dangerous situations.
Drunken drivers are a late-night hazard in Palau.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Palau, the U.S. Federal Aviation Administration (FAA) has not assessed the government of Palau’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Palau’s air carrier operations.
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 Palau are encouraged to register at the Consular Section of the U.S. Embassy in Koror or through the State Department’s travel registration web site, and to obtain updated information on travel and security within Palau.
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 Airai State, in an area known as Omsangel.
There is no street address.
The mailing address is: PO Box 6028, Koror, Palau 96940.
The telephone number is (680) 587-2920/2990.
The fax number is (680) 587-2911.
The Embassy does not issue passports; that function is performed by the Honolulu Passport Agency.
*

*

*
This replaces the Country Specific Information dated July 11, 2008, to update the section on Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu, 1 Aug 2019 02:51:49 +0200 (METDST)

Koror, Palau, Aug 1, 2019 (AFP) - Palau has called on Australia to do more to tackle climate change, saying the Pacific's "big brother" has an obligation to act on an issue that threatens the existence of its small island neighbours.   Australia has launched a diplomatic push it calls the Pacific "step-up" to boost its influence and counter growing Chinese influence in the region.   But Palau President Tommy Remengesau said Canberra's lack of action on climate change risked damaging its standing among Pacific leaders.   "I share the concern of the rest of the Pacific that Australia, as a big brother, can do more than what they're doing right now and should take the lead," he told reporters Wednesday.    "We're asking Australia to take a more active and more partnership role as a big brother in this fight."

Some low-lying Pacific island nations are threatened by rising seas, while others are pummelled by cyclones that have become more regular and powerful due to climate change.   Remengesau said Palau and other nations would make "an impassioned plea" for Australia to do more when the annual Pacific Islands Forum is held in Tuvalu later this month.   "If Australia, which is in the midst of the Pacific, do not take the lead, then it's very hard to expect European countries or others to speak and act on our behalf," he said.   Australia -- led by climate-sceptic Prime Minister Scott Morrison -- recently approved the giant Adani coal mine in Queensland state.

Critics also say the country will only meet its emissions target under the 2015 Paris climate deal by fudging data using "carryover credits" earned under the previous Kyoto deal to get it over the line.   The 11-member Pacific Islands Development Forum this week urged developed countries not to use such credits and called for an immediate halt to the development of any new coal mines.   "By 2100, the coral atoll nations of the Republic of the Marshall Islands, Tuvalu, Kiribati, Tokelau and the Maldives and many (small island developing states) could be submerged," the group warned after a meeting in Fiji.   Australia's conservative government has rejected the call to stop using carryover credits and defended its record on emissions reduction.
Date: Sun, 27 Jan 2019 04:00:35 +0100
By Bernadette Carreon

Koror, Palau, Jan 27, 2019 (AFP) - Swimming with the famous golden jellyfish in Palau can be put back on the bucket list following a two-year ban, but bathers may be stung with a hefty price increase for the pleasure.    The government ordered the famed Ongeim'l Tketau Jellyfish Lake closed to swimmers in 2016 because of dwindling numbers of the unique creature -- blamed on warming waters although with some suspicion sunscreen on bathers may also have contributed. 

The conservation move proved costly for tour operators with the loss of Palau's most popular attraction contributing to a slump in tourism numbers.   But authorities in Koror State, which owns the resource, say stocks are now recovering and tourists are again being welcomed at Jellyfish Lake.  "The jellyfish are returning, tourists are visiting again," Dora Benhart, the outreach officer of Koror State's conservation department said.   Swimming with the jellyfish on Mecherchar island, about a 45-minute boat ride from Koror, is "one of the most unique attractions" Palau has to offer, according to the Visitors Authority chairman Ngirai Tmetuchl.   It is estimated to attract at least two-thirds of the annual visitors to the western Pacific archipelago which peaked at 160,000 in 2015.   The numbers slumped to 108,000 last year which Tmeuchl said was caused by a combination of factors, including restrictions on Jellyfish Lake.

The rare species of golden jellyfish, believed to exist only in this marine lake, does have a sting but it is mild and often undetectable making swimming among them a popular experience.    The jellyfish population, which once swelled to around 20 million, slumped in 2016 because of El Nino, a climate pattern linked to warming waters in the central and eastern areas of the equatorial Pacific.    Palau President Tommy Remenegsau called for the lake to be closed, and while it was never officially shut down by Koror State, the dwindling jellyfish numbers saw a self-imposed ban by tour operators who stopped taking visitors to the island rather than charge them US$100 to see nothing.

- Numbers rising -
With the waters cooling over the past year the jellyfish have increased to numbers strong enough to invite tourists back but Sharon Patris, a research biologist at the Coral Reef Research Foundation said it would take some time to reach "normal numbers" of five to eight million.    A proposal to increase the visiting fee to US$150 is now before the Koror State legislature.    Authorities are also strictly enforcing rules about the use of sunscreen, saying it must be environmentally friendly and applied more than 30 minutes before entering the water.    Although a link between sunscreen and falling jellyfish numbers has been suggested and dismissed, authorities said they wanted to ensure the purity of the water.

Clothes worn by bathers must be thoroughly rinsed before swimming to eliminate the risk of taking "invasive species" into the lake.   Patris added there was a similar fall in jellyfish numbers in 1998 linked to an El Nino event and data showed "the jellyfish did not disappear because of the presence of sunscreen".    There are more than 50 marine lakes in Palau, five of them containing jellyfish but only the one Jellyfish Lake is open to visitors.    The Visitor Authority's Tmetuchl has called for a second lake containing the same golden species of jellyfish to be made available to the public.   This is opposed by conservationists who say it would expose another lake to the same risks as the first.
Date: Thu, 19 Jul 2018 09:58:57 +0200

Taipei, July 19, 2018 (AFP) - Taiwan has stepped in to help its ally Palau attract more tourists after an airline from the Micronesian nation said it was forced to shut under pressure from China.   Taiwan's battle to protect its few remaining official allies has intensified as relations with Beijing deteriorate.   Four former allies of Taiwan have switched diplomatic recognition from Taipei to Beijing since 2016 as China offers economic incentives to jump ship.    China sees Taiwan as part of its territory awaiting reunification, by force if necessary, even though the island views itself as a sovereign nation and is a self-ruling democracy.

Tensions have escalated under President Tsai Ing-wen since she came to power two years ago as she has refused to accept both sides are part of "one China".   Palau has maintained ties with Taiwan but now one of its airlines, Palau Pacific Airways, says it has been forced to suspend operations because of a plunge in Chinese tourists.    A letter from the airline's Taiwanese owner, Sea Passion Group, to Palau's national congress accused Beijing of branding Palau "an illegal tour destination", denting its business.    The airline said it believed it had been targeted "most likely due to lack of diplomatic status".   A Palau-based member of staff from the airline told AFP the shutdown would happen after August and would halt flights to and from Hong Kong and Macau, the only two routes it operates.

Taiwan's foreign ministry said Thursday that Taiwan's national airline, China Airlines, has added two more weekly flights to Palau between June and August "to assist in attracting more overseas visitors".  "Helping our diplomatic allies with economic development is one of the important tasks in promoting bilateral cooperation," it said in a statement.    In 2016, tourists from China made up 47 percent of all visitors to Palau, a Pacific island group with a population of 22,000. Taiwan tourists accounted for 10 percent of visitors.    But in is letter to Palau's congress, Sea Passion Group said the number of air travellers using its flights fell 16 percent from January to June this year against the same period in 2017 and ticket prices dropped 45 percent to $300.

Taiwan's local media reported China had imposed a ban last November on tours to Palau and the Vatican -- also one of Taiwan's allies -- and that agencies could face a steep fine if they run trips to those destinations.    The number of group tourists from China to Taiwan has also plunged in recent years as relations sour.    In addition, Beijing has used it growing clout to force multinational firms to list Taiwan as a province of China, including Australian airline Qantas, clothing supplier Gap and hotel chain Marriott.
Date: Fri, 8 Dec 2017 06:43:29 +0100

Koror, Palau, Dec 8, 2017 (AFP) - Visitors to the tiny Pacific nation of Palau are being made to sign a promise to respect the environment, in an innovative move that authorities hope will curb ecological damage caused by booming numbers of tourists.

Claimed to be a world first, the "Palau Pledge" is stamped onto visitors' passports and must be signed upon arrival in the country, which lies in the western Pacific about halfway between Australia and Japan.   "I take this pledge as your guest, to protect and preserve your beautiful island home," it reads in part.   "I vow to tread lightly, act kindly and explore mindfully."

With crystal clear waters, pristine reefs and abundant sea life, Palau is regarded as one of the world's best diving spots and was once a niche tourist destination.   But visitor numbers have exploded in recent years, particularly from China, straining both infrastructure and the environment.

The symbolic pledge was written with the help of Palau's children and President Tommy Remengesau said it was about preserving the environment for future generations.   "Conservation is at the heart of our culture," he said.   "We rely on our environment to survive and if our beautiful country is lost to environmental degradation, we will be the last generation to enjoy both its beauty and life-sustaining biodiversity."   Palau welcomed almost 150,000 tourists last year, up 70 percent on 2010 figures and the nation of 20,000 has struggled to cope.

Some of the new arrivals have caused outrage among locals by capturing turtles so they can take selfies with them, walking on fragile coral and leaving trash on beaches.   "The Palau Pledge aims to encourage environmentally sound habits in visitors," the government said in a statement.   "If action is not taken now, it will get to the point where it is too late to protect some of the most unique parts of the country."
22nd July 2017

- Palau. 13 Jul 2017. 290 cases confirmed, with 106 cases in June [2017]; in April and May [2017], 3 people with pre-existing medical conditions died.

[Maps of Palau can be seen at
<http://healthmap.org/promed/p/519>. - ProMED Sr.Tech.Ed.MJ]
More ...

World Travel News Headlines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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